Benzodiazepines and Z-drugs Q&As
Published by Bupa's health information team, April 2009.
Answers to questions about benzodiazepines and Z-drugs
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- Can I take benzodiazepines during pregnancy?
- I have heard that benzodiazepines can help people who are dependent on alcohol - is this true?
- Are Z-drugs better for insomnia than short-acting benzodiazepines?
Can I take benzodiazepines during pregnancy?
You shouldn't take benzodiazepines when you're pregnant unless your GP tells you to. If benzodiazepines are used towards the end of your pregnancy or during labour, your baby may have withdrawal symptoms such as low body temperature (hypothermia), difficulty breathing and muscle weakness. If you're taking benzodiazepines when pregnant, it's important that you inform your midwife and obstetrician (a doctor who specialises in pregnancy and childbirth) so they can provide extra care for your baby if he/she needs it.
Explanation
You shouldn't take benzodiazepines during pregnancy unless your GP considers it absolutely necessary. These medicines can cause the same effects in your baby as they do in you, but for babies this can be dangerous.
If you regularly take benzodiazepines when you're pregnant, your baby may have symptoms known as 'neonatal withdrawal syndrome' when you stop taking them, or when your baby is born. The symptoms of withdrawal from benzodiazepines in babies include:
- low body temperature (hypothermia)
- difficulty breathing
- muscle weakness
It's therefore important that you talk to your GP before making any changes in your benzodiazepine medication. You shouldn't suddenly stop taking benzodiazepines without taking advice from your GP. If you're taking benzodiazepines at the end of your pregnancy or during labour, you should inform your midwife and obstetrician so that they can give your baby extra care when he/she is born.
Always ask your GP for advice and read the patient information leaflet that comes with your medicine.
Further information
- electronic Medicines Compendium
www.emc.medicines.org.uk
Sources
- Joint Formulary Committee, British National Formulary. 56th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008:805
I have heard that benzodiazepines can help people who are dependent on alcohol - is this true?
You may be prescribed a short course of benzodiazepines if you have heavy or long-term dependence on alcohol to help you while you're trying to stop drinking. If you're in this situation, benzodiazepines may help you to cope with 'alcohol withdrawal syndrome'.
Explanation
If you drink too much alcohol or are dependent on it, giving up can be very difficult. If you stop drinking or reduce the amount of alcohol you drink, you may get unpleasant symptoms known as 'alcohol withdrawal syndrome'. The symptoms of alcohol withdrawal syndrome are different for everyone but can include shaking, restlessness, difficulty sleeping, nightmares, sweating, racing heart, fever, sickness, abnormal visions (hallucinations) and fits.
Scientists have found that long-term alcohol consumption can cause changes in the brain. These changes affect the neurotransmitter gamma-aminobutyric acid (GABA) system. Therefore, when there is no alcohol, the GABA neurotransmitter system can cause the brain to get overexcited, which contributes to the symptoms of alcohol withdrawal syndrome.
Benzodiazepines increase levels of GABA in the brain and slow down brain activity. Clinical trials have shown that a short course of benzodiazepines can reduce the symptoms of alcohol withdrawal syndrome.
You shouldn't take benzodiazepines for long periods, because this can lead to physical and psychological dependence, which means that it becomes difficult to stop taking them. In addition, more benzodiazepine is needed for it to have the same effect (this is known as tolerance).
Always ask your GP for advice and read the patient information leaflet that comes with your medicine.
Further information
- electronic Medicines Compendium
www.emc.medicines.org.uk
Sources
- Ntais C, Pakos E, Kyzas P, et al. Benzodiazepines for alcohol withdrawal. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No: CD005063.pub2. DOI: 10.1002/14651858.CD005063.pub2. www.cochrane.org
Are Z-drugs better for insomnia than short-acting benzodiazepines?
A review carried out by the National Institute for Health and Clinical Excellence (NICE) concluded that Z-drugs had no clear advantage over short-acting benzodiazepines for the treatment of insomnia.
Explanation
Benzodiazepines help you get to sleep by slowing down brain activity. They do this by increasing the levels of a chemical found in the brain called gamma-aminobutyric acid (GABA). Z-drugs have a different chemical structure to benzodiazepines, but work in the same way. Z-drugs stay in the body only for a short time, which makes it less likely that you will feel sleepy the day after taking them. Some benzodiazepines, such as nitrazepam and flurazepam, stay in the body for a long time, and care must be taken when driving or operating machinery the next day, as the effects of these benzodiazepines may still be present. Not all benzodiazepines last in this way - loprazolam, lorazepam, lormetazepam and temazepam are short-acting. A review carried out by the NICE concluded that Z-drugs had no clear advantage over short-acting benzodiazepines for the treatment of insomnia.
You shouldn't take benzodiazepines or Z-drugs for long periods because this can lead to physical and psychological dependence. This means that you will find it difficult to stop taking them. In addition, you will need to take more of the medicine for it to have the same effect (this is known as tolerance).
You should only take benzodiazepines and Z-drugs in the doses your GP has prescribed for you and only stop taking them as instructed. You shouldn't take more than the recommended dose - an overdose of benzodiazepines or Z drugs can be fatal.
Always ask your GP for advice and read the patient information leaflet that comes with your medicine.
Further information
- electronic Medicines Compendium
www.emc.medicines.org.uk
Sources
- Guidelines on the use of zaleplon, zolpidem and zopliclone for the short-term management of insomnia. National Institute for Health and Clinical Excellence (NICE), 2004. www.nice.org.uk
Related topics
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: April 2009
Benzodiazepines and Z-drugs factsheet
Visit the benzodiazepines and Z-drugs health factsheet for more information.
Rate this page
