Table of contents:
- Benzodiazepines: what are they?
- Benzodiazepines: mechanism of action
- Benzodiazepines: classification
- Benzodiazepines: classification according to the start
- Types of benzodiazepines according to onset
- Benzodiazepines: Classification According to Half-life
- Types of benzodiazepines according to half-life
- Short-lived benzodiazepines
- Types of short-lived benzodiazepines
- Mid-life benzodiazepines
- Half-life types of benzodiazepines
- Long-lived benzodiazepines
- Long-lived types of benzodiazepines
- Benzodiazepines and alcohol
Benzodiazepines are the pharmacological group that the population accesses more easily and frequently, without the need for a related pathology that indicates their use.
How many times have we heard that someone in our environment uses Noctamid or Ortfidal to be able to sleep at night? These two drugs are part of the benzodiazepine family and, together with trankimazin, are the most widely used. However, we must know the peculiarities of benzodiazepines and when deciding to take them, we must follow the instructions of a doctor, since they can generate rapid dependence and tolerance.
If you want to know this pharmacological group so present in our lives, know what it should be used for and what its indications should be, keep reading this Psychology-Online article: benzodiazepines: what they are, mechanism of action and classification.
You may also be interested in: What is Psychoneuroendocrinoimmunology Index- Benzodiazepines: what are they?
- Benzodiazepines: mechanism of action
- Benzodiazepines: classification
- Short-lived benzodiazepines
- Mid-life benzodiazepines
- Long-lived benzodiazepines
- Benzodiazepines and alcohol
Benzodiazepines: what are they?
What are benzodiazepines? Benzodiazepines are the family of psychotropic drugs par excellence in the treatment of anxiety. Although there are also types of benzodiazepines classified in the group of hypnotics, since at high doses they have a hypnotic-sedative effect. Its discovery in the early sixties was a great advance for the treatment of anxiety, because the drug of choice for anxiety disorders were barbiturates, a high-risk pharmacological group due to the short distance between a safe dose and a toxic dose. Therefore, they quickly became the drug of first choice for anxiety disorders and also used as a hypnotic drug.
This pharmacological group has the property of relaxing those who take it and although its main action is against anxiety, its use is also applied as a muscle relaxant, hypnotic-sedative and anticonvulsant. However, although it is a pharmacological group that works very well, like all drugs, benzodiazepines have side effects and risks that the person should be aware of. Benzodiazepines are a very safe pharmacological group, however if their administration is prolonged, they can cause dependence and tolerance.
Its administration tends to be orally, however, in the face of very high agitation or panic attacks, it might be advisable to use its intravenous administration, because it acts more quickly in the body.
Benzodiazepines: mechanism of action
What are benzodiazepines for? How do they work? Benzodiazepines act on the GABA receptor (gamma-amino butyric acid), a neurotransmitter that has the function of creating a relaxing, calming and / or calming effect in our brain, reducing the transmission of nerve impulses between our cells.
The neurotransmitter GABA has an inhibitory effect on our body, that is, it causes cells to slow down their communication speed with each other or to stop transmitting information. A large part of our neurons, almost half, respond to this receptor, which causes that after increasing its action in the brain with the drug, the GABA receptor causes a relaxing effect on our entire body, generating a depressant effect on it.. For this reason, there is a reduction in high levels of anxiety and induces an increase in muscle relaxation and hypnotism.
Benzodiazepines: classification
The classification of benzodiazepines is assigned based on two concepts: the onset of action and the elimination half-life.
Benzodiazepines: classification according to the start
The onset of action refers to the time elapsed since the drug is administered until it reaches its maximum concentration. This time variable will depend on the pharmaceutical form in which it is made, the route of administration, the liposolubility of the drug, that is, the ability of the drug to cross the blood-brain barrier, so that the drug can exert its action, and the time that it takes place until the drug crosses this barrier. The classification based on this variable distinguishes 3 types of benzodiazepines.
Types of benzodiazepines according to onset
- Quick start: maximum drug concentration appears within an hour.
- Intermediate onset: the maximum concentration of the drug appears between one and two hours.
- Slow onset - Peak drug concentration appears in two hours or more.
Benzodiazepines: Classification According to Half-life
On the other hand, the elimination half-life, that is, the time that elapses until the drug is expelled from the body, will depend on the metabolism of the drug, its fat solubility, the presence of active metabolites and the proportion of fat in the body. Among the temporal variability of elimination, 3 types of benzodiazepines have been established.
Types of benzodiazepines according to half-life
- Short: the period of elimination of the drug is equal to or less than six hours.
- Intermediate: the period of elimination of the drug is between six and twenty-four hours.
- Prolonged: the period of elimination of the drug is equal to or more than twenty-four hours.
Let's take a closer look at its classification and which benzodiazepines are part of each type.
Short-lived benzodiazepines
As we have previously indicated, short half-life benzodiazepines remain in our body for six hours or less. Their advantage is that they are the fastest acting group of benzodiazepines, which is why they are frequently used for specific symptoms, such as the onset of anxiety attacks, to treat insomnia or as momentary muscle relaxants, however they are not used for long-term anxiety treatment.
The great problem of this group is that having a short half-life of action, the effect of the drug wears off soon and therefore, the person has the need to want to maintain the effects of this, consuming the drug again, so they tend to generate long-term dependency problems if its consumption is not regulated by a doctor. This is one of the side effects or risks of benzodiazepines. In this group we can find different types of benzodiazepines, also taking into account the onset of action.
Types of short-lived benzodiazepines
- Quick-onset short half-life benzodiazepines: midazolam, brotizolam, clotiazepam, and bentazepam
- Short half-life benzodiazepines with intermediate onset of action: triazolam and loprazolam.
- Slow-onset short-half-life benzodiazepines: zolpidem and zopiclone.
Mid-life benzodiazepines
Intermediate-life benzodiazepines have a half-life of action of between six and twenty-four hours, thereby favoring the reduction of the potential for abuse, due to the fact that their effects are longer in time. In this group we can find different types of benzodiazepines, also taking into account the onset of action.
Half-life types of benzodiazepines
- Benzodiazepines of intermediate half-life with rapid onset of action: temazepam.
- Intermediate half-life benzodiazepines with intermediate onset of action: lorazepam, flunitrazepam, lormatazepam, nitrazepam, alprazolam, bromazepam, and halazepam.
- Slow-onset intermediate half-life benzodiazepines: oxazepam.
Long-lived benzodiazepines
Long-lived benzodiazepines maintain an elimination half-life of more than 24 hours and are therefore well suited for the treatment of long-term anxiety. As an advantage, it should be noted that the drug remains stable in the body for a long period of time, which can have its greatest drawback in the same way, that the drug accumulates in the blood, being able to reach levels of toxicity in blood and / or cause more side effects. In this group we can find different types of benzodiazepines, also taking into account the onset of action.
Long-lived types of benzodiazepines
- Benzodiazepines with a long half-life with rapid onset of action: clorazepate, diazepam, flurazepam and tetrazepam.
- Benzodiazepines with a long half-life with intermediate onset of action: chlordiazepoxide, clobazam, clonazepam, medazepam and quazepam.
- Benzodiazepines with a long half-life with slow onset of action: prazepam and ketazolam.
Benzodiazepines and alcohol
Regarding the administration of benzodiazepines, it is necessary to take into account the possible dangers when interacting with other substances. A question that patients frequently ask is: can you mix benzodiazepines and alcohol? The answer is no. Mixing benzodiazepines and alcohol is very dangerous. Alcohol inhibits the liver enzymes responsible for biotransformation, that is, for transforming drug substances. The consequence of this inhibition is that the concentrations of these substances increase. Therefore, if we take benzodiazepines and alcohol together, alcohol will make the action of the drug greater.
On the other hand, both substances share the main effect, as they are depressants of the central nervous system. Therefore, the effect is enhanced.
The consequences of mixing benzodiazepines and alcohol can be drowsiness, loss of balance, decreased heart rate, shortness of breath and loss of consciousness, among others.
This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
If you want to read more articles similar to Benzodiazepines: what they are, mechanism of action and classification, we recommend that you enter our category of Psychopharmaceuticals.
Bibliography- Bust, EU (2000). Risk factors in benzodiazepine abuse and dependence . Addictive Disorders, 2 (3), 177-182.
- Díaz-Peñaloza, M. (2018). Benzodiazepines and their effects on anxiety . Culture: Journal of the Association of Teachers of the USMP, 32.
- Gámez, M & Indart, I. (1996). Selection of benzodiazepines. Bases for its use in the hospital. Farm Hosp, 21, 117-122.
- Rosas-Gutiérrez, I., Simón-Arceo, K., & Mercado, F. (2013). Cellular and molecular mechanism of benzodiazepine addiction s. Mental Health, 36 (4), 325-329.