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WHAT ARE BENZODIAZEPINES, AND HOW DO THEY WORK?

Benzodiazepines are a class of drugs primarily used for treating anxiety, but they also are effective in treating several other conditions. The exact mechanism of action of benzodiazepines is not known, but they appear to work by affecting neurotransmitters in the brain, chemicals that nerves release in order to communicate with other nearby nerves. One of these neurotransmitters is gamma-aminobutyric acid (GABA), a neurotransmitter that suppresses the activity of nerves. Scientists believe that excessive activity of nerves may be the cause of anxiety and other psychological disorders, and benzodiazepines reduce the activity of nerves in the brain and spinal cord by enhancing the effects of GABA.

FOR WHAT CONDITIONS ARE BENZODIAZEPINES USED?

Benzodiazepines are used for treating:

  • anxiety and panic
  • seizures (convulsions), and
  • insomnia or trouble sleeping.

They also are used for:

  • general anesthesia,
  • sedation prior to surgery or diagnostic procedures,
  • muscle relaxation,
  • alcohol withdrawal and drug associated agitation,
  • nausea and vomiting,
  • depression, and
  • panic attacks.

ARE THERE DIFFERENCES BETWEEN BENZODIAZEPINES?

Benzodiazepines differ in how quickly they start working, how long they continue to work, and for what they are most commonly prescribed.

  • Diazepam (Valium) and clorazepate (Tranxene) have fast onsets of action and usually start working within 30 to 60 minutes.
  • Oxazepam (Serax) has a slow onset, and lorazepam (Ativan), alprazolam (Xanax), and clonazepam (Klonopin) have intermediate onsets of action.
  • Clorazepate (Tranxene), midazolam (Versed), and triazolam (Halcion) are short-acting agents with durations of action of 3 to 8 hours.
  • Alprazolam (Xanax), lorazepam (Ativan), estazolam (Prosom), and temazepam (Restoril) are intermediate-acting agents with durations of action of 11 to 20 hours.
  • Chlordiazepoxide (Librium), clonazepam (Klonopin), diazepam (Valium), flurazepam (Dalmane), and quazepam are long-acting agents with duration of action of 1 to 3 days.

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), lorazepam (Ativan), clobazam (Onfi), and diazepam (Valium) are used for seizure disorders.
  • Estazolam (Prosom), flurazepam (Dalmane), quazepam (Doral), temazepam (Restoril), and triazolam (Halcion) are used for insomnia or trouble sleeping.
  • Midazolam (Versed), lorazepam (Ativan), and diazepam (Valium) are used in anesthesia.
  • Diazepam (Valium) also is used for muscle relaxation.
  • Chlordiazepoxide (Librium) is used for alcohol withdrawal.

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