you are a Savior in time of Need, prepare, sleepless nights, and let the anxiety as if by magic disappear. No wonder, benzodiazepines are the most prescribed medication ever. However, the highly effective sleeping pills and tranquilizers have their pitfalls.
When the first benzodiazepines came in the mid of the last century on the market, it was the lack of euphoria: so far, mainly barbiturates as sleeping pills and tranquilizers, which made it quickly addictive and led to easy poisoning, hoped, the doctors now, to have found an Alternative. In particular, Valium became the box-office hit and was sung by the Rolling Stones ' 1966 "Mother's Little Helper". Because among the consumers, the Housewives, the weathered with the means of everyday life.
In the following decades, other benzodiazepines came on the market. Today, around two dozen drugs of this group in Switzerland are available. They bear names such as Temesta, Seresta, Lexotanil, Dormicum, Xanax or Stilnox. The latter is not a benzodiazepine, but closely related to this.
one in Every Ten is dependent on
How popular such drugs, shows a projection of the health insurance Helsana from the year 2015: Around four million packs of sleeping pills and tranquilizers Doctors prescribe in Switzerland per year, for more than 800'000 patients. A study of addiction monitoring Switzerland to 2016 provides further data, approximately 7 percent of the respondents had sleep from the age of 15 in the last four weeks or sedative taken; in the over 75-Year olds, 18 per cent. About half of the respondents took this for more than a year daily. The 200'000 people are expected.
These Numbers are so volatile, because the benzodiazepines account for the largest proportion of sleep, and sedatives, and not for long-term use. "Benzodiazepines should not be used longer than four to eight weeks," says psychiatrist Marc bird from the centre for addiction of the University disorders Psychiatric clinics in Basel.
The restriction has a good reason. Shortly after the market launch, it turned out that benzodiazepines are addictive – even in low doses. Doctors speak of a "Low-Dose-dependence". As a consequence, especially older people who take benzodiazepines often for insomnia affected.
"patients need to be informed about the risks of long-term use": Marc Vogel, a psychiatrist.
on average, each Tenth, of the benzodiazepines takes longer, dependent, estimates Marc Vogel. Signs of dependency can be withdrawal symptoms such as anxiety, restlessness and sleep disorders, "so exactly are the complaints, which are to combat the patients with the benzodiazepines".
The drugs have in addition to the risk of addiction, other potential side effects such as fatigue, dizziness, concentration and memory problems, or confusion. As benzodiazepines, muscle relaxation, and may occur in the elderly, an unsafe gait and increased Falls. For the Geriatricians, Reto Kressig, Medical Director of the University of geriatrics, Felix Platter in Basel, is the increased risk of falling one of the most serious side effects. "In old age, people break in a crash, often the neck of the Femur," says the old physician. "They are often in up to the end of their days in need of care." Finnish researchers at the University of Helsinki showed in 2006 in a study that about half of the 223 patients studied with femoral neck fractures were under the influence of benzodiazepines.
In recent years, benzodiazepines were more under attack. Individual observational studies have found a relationship between years of ingestion and the onset of dementia. "But this is no proof that the funds promote a dementia," says Reto Kressig. It may be that people are taking with a later dementia rather benzodiazepines because it comes in the advance of the disease often have sleep disorders or Anxiety. It is proved, however, that people age more sensitive to benzodiazepines. "In patients already suffering from a slight dementia, benzodiazepines, disorientation, trigger conditions," says the Geriatrician Kressig. In addition, it may occur with older people more likely to Overdose, because of the slower metabolism of the substances degrade more slowly.
Higher doses-term consequences
Basically, the taking and the higher the dose, the following applies: "The longer, the more likely it is to be expected with unwanted consequences," says psychiatrist Marc bird, and tells of a typical case of a seventy year old female patient. You received a prescription from the doctor for the benzodiazepine drug Lorazepam, since she suffered after the death of her husband's insomnia. For several years she took every night a pill to fall asleep. They rarely took the drug during the day, when she was tense or nervous. At some point, the woman went without the emergency pill out of the house.
As she had after a fall in the hospital and in a multi-bed room, no rest found, it increased the evening dose to two tablets. Back home, she took more and more frequent even during the day, a pill to calm down. Gradually, she increased the dose to four tablets per day. Her children noticed that she seemed lethargic, unfocused it was, and agreements not kept. The son went with the mother of the house doctor referred you to a psychiatrist. This diagnosed a benzodiazepine dependence as well as a slight Depression.
studies show that benzodiazepines are prescribed most frequently by General practitioners and internists.
The dependence of the "little helpers" often progresses insidiously. "The Affected change is not as strong as in the case of an alcohol or cocaine addiction," says Marc bird. "For members, it is often difficult to detect the dependence." In addition, symptoms such as forgetfulness or an unsteady gait are often attributed to the age of the person Concerned.
The woman in the case example, had a standing prescription from the doctor. Studies show that benzodiazepines are prescribed most frequently by General practitioners and internists. For years experts of Addiction, therefore, is that family doctors are the drugs prescribe. "The Patient is in an acute crisis, it may be appropriate for him to Bridge a benzodiazepine," says psychiatrist Marc Vogel. "But the family doctor should encourage and motivate his patients to take further steps."
psychotherapy as a way out
In the case of Anxiety or panic attacks, for example, a so-called cognitive be behavior therapy is advisable. "Of course this is expensive and unpleasant to swallow than a tablet. The Patient must take the time, and his anxiety to expose." But the effort is worth it, because such a treatment to bring the Problem to the root of pack, and the long-term success.
Philippe Luchsinger, President of the General practitioners and paediatricians, Switzerland, defends itself against the criticism, the house doctors would easily make ready benzodiazepines. "We usually prescribe these medications only as a short-term solution," says the General practitioner from Affoltern am Albis, ZH. "Together with the patient we look." So, the house doctors would educate their patients about sleep hygiene measures, and with them the psycho-therapeutic conversations. "In more severe cases, Referral to a psychiatrist or delegate psychotherapists." Sometimes it is difficult, if not impossible, to motivate the patient to a psychotherapy. "There are patients who cannot or do not want to make psychotherapy."
Prescribed tranquilizers are easy: that is Why it is important that Doctors and patients pay attention to a possible dependence. Photo: iStock
to prescribe, In certain cases, Philippe luchsinger considers it justifiable, the means in the long term. "I have patients from my predecessor," says the doctor, leading his practice for over 30 years. "Some of them take 40 years of benzodiazepines to fall asleep, showed up without any problems." The psychiatrist Marc bird from the centre for dependency disorders, acknowledges that in some cases, long term consumption of justified could be – if other treatments have failed. But: "patients must be informed about the risks of long-term use." A cessation should only be used with a medical escort. "A withdrawal of medication is usually more difficult than the of alcohol and often takes weeks or months." The dose is gradually lowered to severe withdrawal symptoms such as seizures or delusion to avoid the ideas. "When patients are motivated, the chances of success are good."
The widow began under the Supervision of your psychiatrist, your tablets consumer bodies to be excluded. After each reduction, she felt restless, slept worse, but only for a few days. At the same time, she began treatment with an antidepressant and cognitive behavioral therapy. The lack of drive, concentration and memory problems were. After a year, she was able to finish all of the therapies, and since then, even without the "little helper" in the bedroom.
(the Swiss family)
Created: 15.04.2019, 21:27 PM