TRANQUILLISERS: FAQs

Tranquilliser addiction is a hidden problem in the UK. Find out more by reading the Frequently Asked Questions below, and visit the BBC Health Message Board to join the discussion on this issue.

What are they used for?

How do they work?

What are the benefits of using them?

What are the disadvantages of using them?

What are the side effects?

Are they addictive?

What are the signs of addiction?

How long do they work for?

Should I stop taking them?

Who can help?

Why are long-term prescriptions still being given?

Is it safe to take them during pregnancy?

---

What are Benzodiazepines?
Benzodiazepine is the name of a family of drugs that include Nitrazepam (Mogadon™), Temazepam and Lorazepam (Ativan™).
Click here for a full list of drugs in the Benzodiazepine family.

Back to top

What are they used for?
They are frequently prescribed for those with anxiety or sleep disorders. Some of the drugs are used as sedatives before surgical and medical procedures (for example Midazolam). Some are used to treat epilepsy.

How do they work?
The drugs operate on receptors in the brain producing a neurochemical called gamma aminobutyric acid. This stops the receptors in the brain receiving stress-causing messages from the outside world. This means the brain's natural chemicals, called endorphins, that are released in stressful situations have less to contend with. This means the patient will feel calmer. But owing to the brain's natural rebalancing this effect will only be short term.

What are the benefits of using them?
When used short-term, benzodiazepines are effective, relatively safe and efficient and have a number of valuable therapeutic effects. They make good sedatives and tranquillisers, and are also used as anticonvulsants. They are good to take as premeditation before surgery and for minor surgical procedures as they impair memory for unpleasant events.

What are the disadvantages of using them?
Problems occur when patients are on Benzodiazepines long term. Adverse effects usually result from excessive dosage, or interactions with other drugs. But as Benzodiazepines have valuable, sometimes life-saving actions, there is no call to ban the drugs. However, prescribing practise must be closely monitored.

What are the side effects?
All drugs have side effects. Benzodiazepines can cause short-term memory impairment, confusion, disinhibition and behavioural changes. Long-term use can bring about depression, epileptic fits, stomach disorders, irregular blood pressure, hallucinations, loss of vision or memory, insomnia and muscle problems. Some Benzodiazepines, such as Diazepam, metabolise slowly so the medication can accumulate in body tissues. Diazepam is recognised as the easiest drug for withdrawal when trying to come off any benzodiazepine. Long-term use can heighten side effects such as lethargy.

Are they addictive?
The Royal College of Psychiatry reported in 1997 that dependence is recognised as a significant risk for patients using Benzodiazepines for longer than 4 weeks. As early as the 1970s it was feared there could be problems with addiction to and withdrawal from Benzodiazepines. It is now widely acknowledged that withdrawal can induce anxiety, insomnia, and, in abrupt withdrawal from long-term use, psychosis and seizures.

What are the signs of addiction?
Long-term users of Benzodiazepines may feel anxious and unable to sleep without the tablets. The drugs create dependency - withdrawal mimics the insomnia and anxiety that often caused people to go on the drug in the first place. However, withdrawal can be very dangerous - medical care is necessary.

How long do they work for?
The Committee on the Review of Medicines issued a warning that there is little convincing evidence that Benzodiazepines continue to work for patients who have been taking them for four months.

Should I stop taking them?
If you are worried about possible addiction you must contact your GP. The effects of trying to quit the tablets without proper supervision can be very serious.

Who can help?
If you are worried about your current medication, consult your GP. If you want help and advice on benzodiazepines you can contact:

• CITA - Counselling and Involuntary Tranquilliser Addiction, 0151 949 0102 or 0151 286 9884
• MIND - the mental health charity offers support and counselling to tranquilliser addicts. They publish a booklet called "Making Sense of Treatments and Drugs: minor tranquillisers."
• HIT, 0151 227 4012 - Liverpool help line number on drugs in general, related to the reduction of drug related harm.
• Benzact, 01670 504155 - offers information and advice on the effects of benzodiazepines during pregnancy
• Bristol & District Tranquilliser Project, 0117 934 9930
• Tranx (Oldham) Self-Help Group, 01457 867355
• The PROMIS Recovery Centre, 0800 374318 - privately run centre dealing with all forms of addiction including prescribed drugs

For further information and contacts, visit the Internet Links page.

Back to top

Why are long term prescriptions still being given?
General Council of GP's representative, Dr Jim Kennedy, believes the reasons long term use continues are varied: Patients choose to stay on the drugs, time and resources for careful withdrawal are not available or due to length of use withdrawal must be undertaken gradually with doses being reduced marginally over a period of months.

Is it safe to take them during pregnancy?
If taken regularly by the mother, benzodiazepines can have adverse effects on the foetus. Developing and newborn babies metabolise benzodiazepines very slowly so that appreciable concentrations may persist for two or more weeks after birth. This causes "floppy infant syndrome" which is characterised by poor muscle tone and difficulties in breathing and suckling. Infants may also develop delayed withdrawal symptoms with irritability, crying and feeding difficulties.