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However, after a few weeks, the body and brain often become used to the benzodiazepine or Z drug. If you take a benzodiazepine or Z drug regularly, the helpful effect on easing anxiety or in helping sleep usually lasts for a few weeks. You then need a higher dose for it to work. This effect is called tolerance. In time, the higher dose does not work and you need an even higher dose and so on. The medicine then gradually loses its effect. The initial dose then has little effect.
For details see our conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions.
If you wish to report a side-effect, you will need to provide basic information about:. The Yellow Card Scheme is used to make pharmacists, doctors and nurses aware of any new side-effects that medicines may have caused.
It is helpful if you have your medication - and/or the leaflet that came with it - with you while you fill out the report.
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Simply talking things over with a friend, counsellor, or with members of a self-help group may also help. Some people have an anxious personality and feel anxious fairly often. (See separate leaflets called 'Anxiety Disorders' and 'Anxiety - Generalised Anxiety Disorder', 'Anxiety - Self Help Guides' and 'Relaxation Exercises' for details.) Treatments for anxiety include: learning to relax, anxiety management courses, cognitive therapy and behavioural therapy. Symptoms of anxiety include: agitation, tension, irritability, palpitations, shakiness, sweating, excess worry, sleeping badly, poor concentration, fast breathing and sometimes a knotted feeling in the stomach and other muscles. Sometimes it is a sudden life crisis such as a bereavement or redundancy. However, if symptoms become severe, you may be advised to take a benzodiazepine medicine for a short time. Although most people will feel anxious at some time, sometimes the symptoms become prolonged and distressing. There are various causes of anxiety.
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A benzodiazepine or Z drug will often work well in the short-term, but is not normally advised for more than 2-4 weeks. If you take it for longer, the medicine may lose its effect (you may become tolerant to the effect) and you may also become dependent (addicted) to it. Benzodiazepines and Z drugs are sometimes prescribed for short periods to ease symptoms of anxiety, sleeping difficulty and sometimes for other reasons. Sometimes the symptoms you are left with after long-term use of these medicines are worse than the symptoms for which they were originally given.
Benzodiazepines work by affecting the way certain brain chemicals (neurotransmitters) transmit messages to certain brain cells. This has a calming effect on various functions of the brain. Benzodiazepines are a group of medicines that are sometimes used to treat anxiety, sleeping problems and other disorders. Examples include: diazepam, lorazepam (trade name Ativan), chlordiazepoxide, oxazepam, temazepam, nitrazepam, loprazolam, lormetazepam, clobazam and clonazepam. In effect, they decrease the excitability of many brain cells.
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However, there are other ways of helping to get a good night's sleep. A short course of a benzodiazepine or a Z drug may be prescribed if a medicine is felt necessary to help with sleeping difficulty (insomnia). These are described in another leaflet called ' Insomnia (Poor Sleep)'. A separate leaflet called 'Insomnia - Sleeping Tablets' gives more details.
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Your doctor will advise on dosages, time scale, etc. However, many people develop withdrawal symptoms if they suddenly stop taking a benzodiazepine or Z drug. To keep withdrawal effects to a minimum, it is often best to reduce the dose of the medicine gradually over a number of weeks or months before finally stopping it. There is also another leaflet called Stopping Benzodiazepines and Z Drugs which gives details. Some people can stop taking benzodiazepines or Z drugs with little difficulty. If you have been taking a benzodiazepine or Z drug for over four weeks and want to come off it, it is best to discuss the problem with a doctor. Mind.
For a full list of possible side-effects whilst taking any tablet, read the leaflet that comes with the packet of tablets. Even if you take a benzodiazepine or Z drug for a short time, you may feel drowsy during the daytime. Some people have described themselves as being in a zombie state when they were taking a benzodiazepine on a long-term basis. Some people, especially older people, are at greater risk of having a fall and injury because of the drowsiness. If you drive, you may be more likely to be involved in a car crash.
The problems with their long-term use were not known. Therefore, most doctors will now only prescribe benzodiazepines and Z drugs for a short period. In 1981, benzodiazepines were the most commonly prescribed medicines in western countries. It was because benzodiazepines worked so well to ease symptoms of anxiety and poor sleep that many people came back for more. However, it is now known that if you take a benzodiazepine or Z drug for more than 2-4 weeks, you may develop problems (see below). Some people started to take them regularly. When benzodiazepines were first used they were thought to be safe.
Withdrawal symptoms may not start for two days after stopping the tablet and tend to be worst in the first week or so. But note: you are unlikely to become dependent on a benzodiazepine or Z drug if you take it for a short period only. Therefore, you may end up taking the medicine to prevent withdrawal symptoms but, because of tolerance, the medicine is no longer helping the original anxiety or sleeping problem. The duration of withdrawal symptoms varies but often lasts up to six weeks and sometimes longer. Some people have minor residual withdrawal symptoms for several months.
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However, if your symptoms are eased, you may be able to cope better with any problems. If you are not used to taking benzodiazepines or Z drugs, the first doses are usually good at easing symptoms of anxiety or promoting sleep. Benzodiazepines and Z drugs work best in situations where anxiety or sleeping difficulty is expected to last only a short while. However, a short course may help you over a particularly bad spell. You can usually stop a benzodiazepine or Z drug without any problems if you take it for just a short period of time (no more than 2-4 weeks). A benzodiazepine does nothing to remove any underlying cause of anxiety such as a life crisis. They are not so useful if you have an ongoing anxious personality or long-term sleeping difficulty.
A large dose is commonly given as a sedative during medical procedures that may cause anxiety or discomfort. The medicine not only reduces anxiety but also has an amnestic effect. Some benzodiazepines are occasionally used to treat muscle spasm and certain types of epilepsy as they can prevent seizures. A dose of a benzodiazepine is often given as a pre-med to reduce anxiety before an operation. This means that you do not remember much about the procedure.
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Possible withdrawal symptoms include:. There is a good chance that you will become dependent on a benzodiazepine or Z drug if you take it for more than four weeks. This means that withdrawal symptoms occur if the tablets are stopped suddenly. In effect, you need the medicine to feel normal.
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If you think you have had a side-effect to one of your medicines you can report this on the Yellow Card Scheme. You can do this online at the following web address: www.mhra.gov.uk/yellowcard.
Strictly speaking, Z drugs are not benzodiazepines but are another class of medicine. However, they act in a similar way to benzodiazepines. (They have a similar effect on the brain cells as benzodiazepines.) Z drugs have similar long-term usage problems as benzodiazepines. Medicines called zaleplon, zolpidem and zopiclone are commonly called the Z drugs.
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