# Benzodiazepines --- **Benzodiazepines** are a class of [[psychotropics|psychotropic]] medicines that works to calm or sedate a person. Often used for acute mania, especially patients who are agitated, dangerous or not sleeping at all. We need to do something this pattern. Sometimes they are part of the treatment of [[bipolar disorder]], but there are risks. Risk of tolerance, dependence, withdrawal, increased risk of fall and dementia/delirium. It's also dangerous in combination with alcohol (which patients are not often completely honest about). If you need a Xanax to get onto the airplane, that's just like taking a shot. This is a short term occasional use of a benzo and a really appropriate use for it. Taking it PRN like twice a day...well maybe this is over prescribed. They're a very commonly proscribed and also a drug of abuse. But they work, so they're still proscribed. It's benefit is it's danger. They work quickly too. But this just means it's being reinforced. And people will have real and true problems and they get an Ativan scrip, and they feel better. And they use up their Ativan, and come back for the medicine that helped them, and get accused of med seeking. They can be really useful and treat real problems. But we proscribe them in ways that set patients up for failure, and we blame the patients. Providers will try to come up with rule for themselves (give small amounts, more frequent visits, UAs) and try to say this will help. They really have to weigh the benefits and risks. ## Mechanism of Action They work by increasing the level of [[GABA]] in the brain, which slows down all the signals. Technically you're not supposed to take them for more than 2-4 weeks. ## Adverse Reactions The effects of benzodiazepines are similar to the effects of alcohol: - you're sedated - you feel better - you are disinhibited ## Examples Benzodiazepines all have a "-zep-" in the name. Common benzodiazepines include: - **diazepam** (Valium) - **alprazolam** (Xanax) - **clonazepam** (Klonopin) - **lorazepam** (Ativan) ___