Benzodiazepine use is harmful

Benzodiazepines have several actions such as anxiolytic, sedative/hypnotic, muscle relaxant and anticonvulsant. They are used for a variety of conditions, particularly anxiety and insomnia. However, they have been prescribed widely and often inappropriately. Withdrawal syndrome, tolerance, and dependence are commonly known side effects of benzodiazepines. However, there are many other unwanted effects of this type of drugs that have to be kept in mind, when prescribing. Although benzodiazepines reduce tension and aggression, they can also rarely lead to a release of aggression by reducing inhibitions in individuals with a tendency to aggressive behavior. This possible effect should be remembered when prescribing for those judged to be at risk of child abuse, or for any person with a previous history of impulsive aggressive behavior. Drowsiness, poor concentration, ataxia, dysarthria, motor incoordination, diplopia, muscle weakness, vertigo and mental confusion caused by benzodiazepines can affect driving skills and the operation of potentially dangerous machinery. Among the elderly, the risk of drug interactions, psychomotor slowing, cognitive dysfunction and paradoxical disinhibition may be amplified. Benzodiazepine use in the elderly is associated with an increased rate of falls that cause hip and femur fractures. Benzodiazepines may also increase the risk for delirium. An association has been noted between benzodiazepine use and depressive symptoms and, in some cases, the emergence of suicidal ideation. Although the mechanism of this action is unclear, benzodiazepine-related depression might occur as a physiologic result of a reduction in central monoamine activity. Benzodiazepines cross the placenta and are classified as class D teratogens. They may lead to the development of dependence and consequent withdrawal symptoms in the fetus. Benzodiazepines are excreted in breast milk and thus are usually contraindicated in breast-feeding mothers. In conclusion, before prescribing benzodiazepines, it is always crucial to remember possible and frequent problems related to benzodiazepine use and seek the causes of anxiety and to try to modify them.