How Do Benzodiazepine Anxiolytics Work?

Benzodiazepine anxiolytics are medications prescribed to treat anxiety and related disorders.Benzodiazepineswork on thecentral nervous systemto reducehyperactivityin the brain and induce a calming effect. Benzodiazepine anxiolytics are also used for sedation, as muscle relaxants and to prevent seizures.

Benzodiazepines work on the limbic system of the brain, which regulates emotional and behavioral responses, and reticular formation which regulates sleep and consciousness. Benzodiazepines stimulate the activity of gamma aminobutyric acid (GABA), a chemical messenger (neurotransmitter) in the brain that inhibits nerve signals.

Benzodiazepines bind to GABA receptors, protein molecules on the surfaces of nerve cells (neuron) that respond to GABA, and increase the inflow of chloride ions, enhancing GABA’s effects. GABA inhibits electrical activity in the brain and produces sedation.

Benzodiazepine anxiolytics may be administered as:

• 口语:Tablets, capsules, solutions and syrups
• Injections:
  • Intravenous (IV): Injected into the vein
  • Intramuscular(IM): Injected into the muscle
• Rectal:Gel applied inside therectum

Benzodiazepine anxiolytics are used to treat the following conditions:

FDA-Approved

• Anxiety
• Anxiety disorders
• Panic disorder
• Depression with anxiety
• Preoperativeapprehension and anxiety
• Seizure disorders
• Acute alcohol withdrawal
• Endoscopy
• Preoperative sedation andanterograde amnesia(short-term loss of memory)
• Anesthesiainduction and maintenance
• Sedation of intubated/ventilated patients
• Sedation in theICU
• Procedural sedation
• Muscle relaxant
• Insomnia (short-term treatment)
• Status epilepticus(a medical emergency, when a seizure lasts longer than five minutes)

Orphan designation:

• Hyperekplexia(a rare hereditaryneurologicaldisorder that causes excessive startle reaction to sudden noise or touch)
• Recurrent, acute, repetitive seizures
• Repetitive seizures caused byDravet syndrome, a rare type ofepilepsy
• Organophosphoruspoisoning(exposure to aneurotoxicsubstance that can cause muscle weakness, cramps andparalysis)

Off-label uses:

• Premenstrual syndrome
• Essential tremor
• REM sleepbehavior disorder
• Burning mouth syndrome
• Tardive dyskinesia (a neurological disorder that causesinvoluntaryrepetitive movements)
• Chronic insomnia
• Chemotherapy-induced nausea and vomiting
• Smoking cessation

Side effects of antianxiety agents may include the following:

• Somnolence(drowsiness)
• Depression
• Headache
• Constipation
• Xerostomia(dry mouth)
• Ataxia(impaired coordination, balance and speech)
• Diarrhea
• Nausea
• Vomiting
• Bloating
• Increased or decreased appetite
• Weight change
• Nasalcongestion
• Fatigue
• Lightheadedness
• Sedation
• Dizziness
• Vertigo
• Depression
• Euphoria
• Delirium
• Memory impairment
• Amnesia(memory loss)
• Irritability
• Cognitivedisorders
• Insomnia
• Confusion
• Disorientation
• Nervousness
• Disinhibition
• Talkativeness
• Vividdreams
• Maniaandhypomania
• Suicidal ideation and attempt
• Paradoxical reactions such as:
  • Anxiety
  • Excitation and agitation
  • Anger, hostility and aggression
• Dysarthria(speech disorder, slurred speech)
• Asthenia(weakness)
• Akathisia(restlessness)
• Muscle weakness
• Rigidity
• Muscle cramps
• 不稳定
• Accidental falls, injuries and fractures
• Extrapyramidal symptoms (drug-induced movement disorders)
• Tremor
• Convulsion/seizures
• Worsening tonic-clonic seizures
• Decreased or increased salivation
• Blurred vision
• Visual disturbances
• Diplopia(double vision)
• Nystagmus(involuntary eye movement)
• Tinnitus(ringing in the ears)
• Edema
• Local effects from IV administration such as:
  • Pain and swelling
  • Phlebitis (inflammation of veins)
  • Thrombophlebitis(phlebitis withblood clotin vein)
  • Carpal tunnel syndrome
  • Tissuenecrosis
• 体温过高(高温)
• Hypersensitive reactions such as:
  • Rash
  • Dermatitis
  • Angioedema(swelling in the tissue under the skin ormucousmembranes)
  • Peripheral edema
  • Stevens-Johnson syndrome(a rare medical emergency with flu-like symptoms and a painful rash)
• Apnea(cessation of breathing)
• Sleep apnea
• Respiratory depression
• Decreasedrespiratory rate
• Oxygen desaturation
• Upper respiratory infection
• Rhinitis(inflammation of thenasal passage)
• Coughing
• Hiccups
• Syncope(fainting)
• Hypotension(low blood pressure)
• Diastolichypotension
• Hypertension(high blood pressure)
• Diastolic hypertension
• Systolichypertension
• EEGabnormalities
• Bradycardia(slow heartbeat)
• Tachycardia(rapid heartbeat)
• Blood dyscrasias (disorders) such as:
  • Neutropenia (lowblood countof neutrophils, a type of immune cells)
  • Agranulocytosis(lowgranulocytes, immune cells with granules)
• Difficultmicturition(urination)
• Urinary frequency
• Urinary retention
• Incontinence
• Hepatic dysfunction
• Increased bilirubin (jaundice)
• Increased liver enzymes
• Hepatitis (liver inflammation)
• Hepatic failure
• Menstrual disorders
• Increase or decrease inlibido
• Impotence
• Hyperprolactinemia (highprolactinlevels in the blood, which can induce abnormal breast milk production and other hormonal disorders)
• Galactorrhea(abnormal milk production and leakage)
• Gynecomastia (breast tissue development in males)

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Genericand brand names of benzodiazepine anxiolytic drugs include:

• 阿普唑仑
• Ativan
• Byfavo
• chlordiazepoxide
• chlordiazepoxide/amitriptyline
• clonazepam
• clorazepate
• Diastat
• Diastat AcuDial
• diazepam
• Klonopin
• Librium
• lorazepam
• midazolam
• oxazepam
• remimazolam
• Seizalam
• TranxeneSD
• Tranxene T-Tab
• Valium
• Xanax
• Xanax XR