Benzodiazepines: Types, Side Effects, Withdrawal, and More

All of the nonbenzodiazepine agents are approved only for the treatment of insomnia. After reviewing your dog’s medical history and assessing their symptoms, your veterinarian may suggest treatments other than diazepam. For instance, BMC Veterinary Research notes that intravenous fluid therapy, in conjunction with other methods, can correct the electrolyte imbalances that can lead to seizures. Dr. Amanda Hansberger, the medical director of Drumm Veterinary Hospital in Castleton-on-Hudson, NY, notes that veterinarians use diazepam to treat acute seizures in dogs. While she acknowledges that the medication is helpful, she says there are many safer or more effective alternatives. In conclusion, while further research is needed to categorically conclude that long-term use of benzos causes dementia, the evidence strongly points to the perils of long-term use of benzos.

Ativan Side Effects

The main driving factor for dependence is the development of tolerance, causing users to need increasing doses for the same symptom relief [18]. BZDs represent one of the most widely prescribed drug classes in the United States. They are used for immediate symptom relief of anxiety, epilepsy and other seizure disorders, spasticity from CNS pathology, catatonia, sleep disorders such as insomnia, and withdrawal from alcohol and other BZDs [3]. Captodiamine is a diphenhydramine-related compound that does not work at histamine receptors as diphenhydramine does and its mechanism of action is unclear [70]. This drug has also been studied in the context of both BZD replacement and withdrawal as a potential treatment [70]. One study showed that replacing BZD with a 45 day captodiamine led to a decrease in severity of withdrawal symptoms in patients taking BZD for six months [70].

Diazepam (Valium) for Dogs: Uses, Side Effects, and Alternatives

  • However, this study was limited by a small sample size, so further randomized clinical trials need to be conducted to assess the efficacy of gabapentin treatment in BZD -dependent MMT patients [68].
  • Withdrawal from benzodiazepines is considered to be particularly dangerous, and in some instances, it can be fatal.
  • The unborn fetus is at high risk for “floppy infant syndrome,” characterized by muscle laxity, failure to suckle, and oversedation.
  • Another study that tested a different standardized education protocol showed more promising results [73].

One of the most well-studied BZDs in the setting of withdrawal is alprazolam. Due to its short half-life, and rapid absorption, alprazolam is distinguished as one of the most rapid-acting BZD with fastest relief of symptomology, increasing its abuse liability [54]. Alprazolam is widely used as monotherapy for panic disorder and anxiety and was found superior to other forms of monotherapy for these conditions including other BZD, non-SSRI antidepressants, and buspirone. This superior effect is thought to be due to its unique alpha-2 adrenergic activity, enhancing its potency for relieving panic and anxiety disorders. This same mechanism is also thought to be the cause behind alprazolam’s strong rebound hyperadrenergic effects with cessation [54,55].

4. Special Populations and Withdrawal

Currently, a gradual taper with clonazepam is used as maintenance therapy for BZD-dependent patients. However, it still carries the risk for abuse and dependence since this is also a BZD, albeit a slow-acting one [67]. Abrahamsson et al. investigated the relationship between hypnotic drug overdose versus non-overdose deaths in patients on opioid maintenance therapy. Despite the increase in risk, less than 13% of the non-overdose deaths were trauma related. A study investigating the prescription of opioids and BZD in veterans showed an increased risk of overdose death in veterans who have prescriptions for both BZD and opioids at the same time [50].

Can I become addicted to benzodiazepines?

People who use them in the long term may need to withdraw their use over a 3–12 month period that their doctor should oversee. Diazepam affects each dog differently, with some dogs experiencing more side effects than others. Some side effects are simply a result of the dog’s muscles relaxing, which may manifest as them walking unsteadily or trembling. Side effects may include fatigue, increased appetite, weakness, aggression or excitement.

Benzodiazepine Side Effects

Benzodiazepines work by blocking excessive activity of nerves in the brain and other areas in the central nervous system. This was in addition to a previous warning about the risks of taking benzodiazepines concurrently with opiates, which could lead to death (4). According to certain 2019 recommendations, people with severe anxiety or benzodiazepine withdrawal panic attack disorder should be prescribed the lowest effective dose of benzodiazepines for no more than 2 to 4 weeks. People with insomnia should be prescribed low doses of benzodiazepines for up to 1 week. As mentioned earlier, benzodiazepine abuse alone does not typically result in death (though withdrawal can be life-threatening).

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