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
"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)