Benzodiazepine mental effects

Several studies have shown that impairment of a person s cognitive or mental function can occur in people taking benzodiazepines. These effects can include problems such as lapses of memory, and confusion. For example, college students who take benzodiazepines before exams to help them relax or sleep may not remember some of what they have been studying. 

Paradoxically, when taken with other drugs, melatonin may have very different mental effects. It tends to stimulate some of the biochemical effects caused by methamphetamines it can end up aggravating insomnia, instead of causing sleepiness, when taken with these drugs. Taking melatonin with benzodiazepines has been reported to cause anxiety. 

From alcohol and methamphetamine to Prozac, Valium, lithium, and Zyprexa, psychoactive substances disguise their adverse mental effects for the user. A person grossly mentally impaired by stimulants, benzodiazepine tranquilizers, mood stabilizers, or neuroleptics is likely to have little idea about how dysfunctional he or she has become. When the individual does perceive a change in himself or herself, positive or negative, it is almost never attributed to the causative agent the drug. If the individual feels euphoric, it is attributed to good fortune and especially... 

Mental Ayurvedic compound herbal preparation. controlled animal study showed efficacy in reversing acute benzodiazepine withdrawal effects. 

Kava should not be used with alcohol, benzodiazepines, barbiturates or other sedatives because of their additive effects. In one case, coma resulted from mixing alprazolam and kava. Patients have complained that kava, while relaxing the body, may be less effective for mental anxiety with obsessive or racing thoughts than are the benzodiazepines. 

CNS agents of the 1,4 benzodiazepine class presumably exert their effects by binding at stereo specific receptors at several sites within the central nervous system (CNS). Alprazolam like other benzodiazepines exerts its anxiolytic action by potentiating GABA activity. GABA is a neurotransmitter which inhibits the CNS activity. Alprazolam acts preferentially in midbrain, ascending reticular formation (which maintains wakefulness) and on limbic system (thought and mental functions). 

Disadvantages of the benzodiazepines include the risk of dependence, depression of central nervous system functions, and amnestic effects. In addition, the benzodiazepines exert additive central nervous system depression when administered with other drugs, including ethanol. The patient should be warned of this possibility to avoid impairment of performance of any task requiring mental alertness and motor coordination. In the treatment of generalized anxiety disorders and certain phobias, newer antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are now considered by many authorities to be drugs of first choice (see Chapter 30). 

Few studies have examined the effects of benzodiazepines on other cognitive abilities. Rusted et al.170 reported that 5 and 10 mg diazepam impaired performance on a logical reasoning test, but had no effect on a mental rotation task. Judd et al.178 found that 30 mg flurazepam, but not 15 mg midazolam, impaired arithmetic (addition) abilities the day after drug administration. In contrast, flurazepam had no effect on reading comprehension. 

Kava contains a substance called dihydrokavain, which is a mild sedative and pain reliever. Preliminary research shows that kava reduces nervous anxiety, tension, and agitation, although these effects usually take at least a week, and often a month or more, to set in. Although other anti-anxiety drugs such as benzodiazepines are more effective than kava, the herb does not seem to impair mental functioning or reaction times the way benzodiazepines do. 

Adverse effects of flumazenil include agitation, confusion, dizziness, and nausea. Flumazenil may cause a severe precipitated abstinence syndrome in patients who have developed physiologic benzodiazepine dependence. In patients who have ingested benzodiazepines with tricyclic antidepressants, seizures and cardiac arrhythmias may occur following flumazenil administration. Transient improvement in mental status has been reported with flumazenil when used in patients with hepatic encephalopathy. 

It is not clear that so-called antipsychotic drugs are superior to other types of drugs with sedative effects but different mechanisms of action. Lithium, benzodiazepines and opium have been shown to be comparable to neuroleptics in the treatment of psychotic states in some studies. The ability of the neuroleptic drugs to reduce the most characteristic symptoms of psychosis such as hallucinations, delusions and thought disorder have often been interpreted as evidence of their specifically antipsychotic or antischizophrenic action (The National Institute of Mental Health Psychopharmacology Service Center Collaborative Study... 

Kalachnik JE, Hanzel TE, Sevenich R, Harder SR. Benzodiazepine behavioral side effects review and implications for individuals with mental retardation. Am J Ment Retard 2002 107(5) 376-410. 

A 23-year-old military officer on active duty took diazepam 5 mg tds and ibuprofen for back spasms. Three days later he was found sitting in a church, having assumed a previous role from his past life. He identified the date as 14 months before and his memory before that time was intact. However, he had no memory of events during the previous 14 months. There were no symptoms suggesting a schizophrenic disorder and his mental function was normal. His symptoms resolved within 24 hours of withdrawal of diazepam, except for amnesia of the event. He assumed his correct identity and was aware of the correct date. He had taken ibuprofen in the past with no adverse effects and this was his first exposure to a benzodiazepine. No other medications were involved and a full medical review found no cause for his symptoms other than diazepam use. 

A new benzodiazepine, RO 5-4556 (26), proved effective in treatment of anxiety, tension and depressions Side effects were minimal. Human mental and motor performance were not... 

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