Benzodiazepines, adverse effects, paradoxical effects, addiction, withdrawal

Benzodiazepines, the most commonly prescribed drugs in the western world, are considered safe and effective drugs for short-term administration. They are used as sedatives/hypnotics, anxiolytics, anticonvulsants, muscle relaxants and amnesic agents for minor surgery. However, when used for long term, they lose much of their therapeutic efficacy and may also produce a large range of adverse effects: impaired psychomotor performance, ataxia, muscle weakness, vertigo, poor memory and mental confusion, apathy, joint and muscle pain. Occasionally benzodiazepines produce paradoxical stimulant effects and provoke aggressive and hyperactive behaviour, increased anxiety, irritability, nightmares, permanent insomnia, and exhaustion. They can also aggravate depression and provoke suicide. Addiction is common. Withdrawal symptoms can be severe.

According to Heather Ashton, emeritus professor of clinical psychopharmacology, many long-term benzodiazepine users will have long-term, possibly permanent physical problems even after they stop. For Dr. Ashton’s manual: Benzodiazepines: How They Work and How to Withdraw please see

Akathisia: a serious life-threatening adverse effect found most commonly
with antidepressant medications

Jay S Cohen MD expert on medications and side effects, associate professor of preventive medicine, and author of Over Dose: The Case Against the Drug Companies writes about akathisia:

"The first type of akathisia occurs most commonly with antidepressant medications. Acute anxiety, panic, restlessness, intense physical agitation, mental turmoil, fears of losing one's mind, create a state that is difficult for people to bear. In severe cases, thinking may become disorganized, and judgment is often impaired. Behaviour can become impulsive. Suicidal thinking may occur. Severe akathisia is a medical emergency. Because of the seriousness of this reaction, all antidepressant medications carry black box warnings in their package inserts. In addition, antidepressants such as Prozac specifically include akathsia among their lists of adverse reactions.

Another form of akathisia is seen with medications known as neuroleptics. These medications are also known as antipsychotics and frequently administered to people with mania or schizophrenia. These drugs can trigger an akathisia that resembles some aspects of Parkinson's disease. This akathisia produces symptoms that are mainly physical, such as a constant need to move around, to pace, or be in motion." "Many doctors are not familiar with akathisia and tell patients to continue taking the medication."

Akathisia can occur not only with antidepressants and neuroleptics, but also with other drugs. Dr. Cohen's recently reported on akathisia related to the use of Cipro. Cipro is an antibiotic! and the 11th most prescribed drug in the U.S. (1999)