Benzodiazepines are drugs that can be used on medical prescription, especially for the treatment of anxiety, tension, fear and insomnia when medication is justified. Benzodiazepines include e.g. diazepam, oxazepam, alprazolam, temazepam, chlora-azepoxide, clonazepam and nitracepam. Some hypnotics (including zopiclone and zolpidem) are benzodiazepine-like medicines that act like benzodiazepines.
Benzodiazepines should only be prescribed based on careful consideration
Although benzodiazepines are effective and fast acting, they are not well suited for the treatment of long-term syndromes such as anxiety disorders. However, other current drugs, such as benzodiazepines, do not have the same anxiety-reducing effect without immediate side effects. In the treatment of anxiety disorders, benzodiazepines can be used in the early stages of treatment to accelerate, for example, the response of SSRI medication or to reduce the initial drawbacks of SSRIs.
The majority of patients receiving benzodiazepine treatment do not suffer from drug dependence or, at least, therapeutically uncontrolled drug addiction. However, benzodiazepines and their hypnotics may cause a risk of harmful physical and / or psychological dependence and abuse. At least at high doses, benzodiazepines may impair the patient’s memory functions, and especially in the elderly, they may increase the risk of tipping. Benzodiazepines can cause daytime fatigue and e.g. impairs your ability to drive. Concomitant use of benzodiazepines and alcohol can have very dangerous side effects. Your doctor should only prescribe these medicines based on careful consideration. If a patient suffering from anxiety disorder or depressive disorder needs long-term medication, consideration should be given to the appropriate use of other classes of drugs.
Physical dependence, or psychological dependence on the patient, as termination symptoms, makes it difficult to stop taking unnecessary or unnecessary medication. Therefore, treatment with benzodiazepine or sleeping pills should be as short as possible and generally last no longer than 4 to 12 weeks. This time also includes gradual discontinuation of drug therapy. Most patients who are prescribed benzodiazepines do not develop drug dependence. However, due to the high number of patients receiving these drugs, the problem of addiction and abuse is very high. Benzodiazepines can be used for intoxication purposes and are transported to the street trade. The risk of developing addiction increases with increasing dose and prolonged treatment time. As physical dependence develops, sudden discontinuation of treatment causes withdrawal symptoms and may also temporarily worsen anxiety, tension and insomnia. Withdrawal symptoms may even include problems with consciousness or seizures. Therefore, after regular use, the dosage of benzodiazepine medication should be reduced gradually and appropriate monitoring should be performed during the withdrawal period.
Thus, benzodiazepines and their hypnotic drugs are abusive and the physician must take them into account when deciding on the prescription of the medicine by the Ministry of Social Affairs and Health. The regulation states that special care and caution should be exercised when prescribing an illicit drug. The prescriber should, if possible, monitor the actual use of the drug to prevent the development of drug dependence. The treatment of a drug addict and a patient with suspected drug dependence should, where possible, be concentrated on a single doctor. Iteration of drug prescription densely dense, eg every 7-10 days, and / or pharmacy contracts prevent patients from falling into uncontrolled mixed use. Patients should not be prescribed medication for abuse at the first visit unless the prescriber determines that medication is necessary. First aid prescriptions must be limited to small.
Anxiety, tension and insomnia can be treated according to current knowledge without significant risk of actual dependence or increase in doses of antidepressants (antidepressants), which are often effective in the treatment of long-term anxiety disorders such as social tension or panic disorder. In the long-term treatment of anxiety disorders, an antidepressant drug should be used primarily, regardless of whether the patient is also depressed. Long-term and especially high-dose benzodiazepine therapy should only be used if the antidepressant treatment does not achieve the desired result or if the antidepressant treatment cannot be used due to its adverse effects. Patients suffering from depression or anxiety disorders should be provided with access to psychotherapy or other psychosocial treatments so that drug treatment does not become the only form of treatment used. Psychosocial therapies can be used to promote proper medication and thus help the patient to give up on inappropriate drugs.
Although, according to current treatment practice, benzodiazepines are not recommended for long-term and large-scale use, such use may in individual cases be medically justified. In some patients, severe anxiety symptoms persist for years, and despite the development of physical dependence, they need long-term and regular treatment. In all patients, benzodiazepines cannot be switched to drugs that do not cause addiction.
When prescribing the drug, remember the appropriate patient records
When considering the need for long-term treatment with benzodiazepine, the benefits and drawbacks of drug therapy, the possibility of other treatments, and other factors that affect the assessment of the treatment should be carefully weighed. These patients should be given a specific treatment plan for the objectives of the drug treatment and the future use of benzodiazepines: whether the patient is trying to wean the use of benzodiazepines, or at least to reduce their use, or whether the patient belongs to a group that is justified to continue long-term, even high-dose medication. Such patients should be in close contact with appropriate care. The need for medication and should be evaluated frequently.