Benzodiazepines (cont.)

Are there differences between benzodiazepines?

Benzodiazepines differ in how quickly they work, and for what they are most commonly used.

• Diazepam (Valium) and clorazepate (Tranxene) have fast onsets of action,
• oxazepam (Serax) has a slow onset, and
• lorazepam (Ativan), alprazolam (Xanax), and clonazepam (Klonopin) have intermediate onsets of action.

Although most benzodiazepines are used interchangeably, some are most commonly used for certain conditions.

• Alprazolam (Xanax), chlordiazepoxide (Librium), chlorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), and midazolam are used for anxiety disorders;
• clonazepam (Klonopin), clorazepate (Tranxene), and diazepam (Valium) are used for seizure disorders;
• estazolam, flurazepam, quazepam (Doral), temazepam (Restoril), and triazolam (Halcion) are used for insomnia;
• midazolam, lorazepam (Ativan), and diazepam (Valium) are used in anesthesia;
• diazepam (Valium) also is used for muscle relaxation;
• chlordiazepoxide (Librium) is used for alcohol withdrawal.

What are the side effects of benzodiazepines?

The most common side effects associated with benzodiazepines are:

• sedation,
• dizziness,
• weakness, and
• unsteadiness.

Other side effects include:

• a feeling of depression,
• loss of orientation,
• headache, and
• sleep disturbance.

All benzodiazepines can cause physical dependence. Suddenly stopping therapy after a few months of daily therapy may be associated with withdrawal symptoms which include a feeling of loss of self-worth, agitation, and insomnia. If benzodiazepines are taken continuously for longer than a few months, stopping therapy suddenly may produce seizures, tremors, muscle cramping, vomiting, and sweating. In order to avoid withdrawal symptoms, the dose of benzodiazepines should be tapered slowly.