These values all change in people who are tolerant both because the drug may be eliminated more rapidly as well as because the nervous system may develop resistance to the effects of these medications. In persons or animals that have never experienced these drugs, the following table illustrates roughly how powerful these are: Table 1 - Activity and Time constant of common benzodiazepines Drug In particular, how strong are they (we will call this activity), how long do they last in the blood, how long does their effect last in the brain, and how does this all change as people develop tolerance. There are many interesting things to consider concerning how these drugs are handled in the body. how long does the effect of these drugs last ?). Shorter duration agents, such as lorazepam, are probably safer than the longer duration drugs (such as clonazepam) simply because there is less drug in the body considered over 24 hours. Very long acting benzodiazepines are not helpful for relief of vertigo. This is also sometimes seen with clonazepam. Use of alprazolam (Xanax)įor vestibular suppression is best avoided because of the potential for a difficult withdrawal Nevertheless, low doses of diazepam (Valium) (2 mg) can be quite effective for dizziness.Ĭlonazepam (Klonopin), is as effective a vestibular suppressant as lorazepam
Fall risk is increased in the elderly by roughly the same proportions. Higher incidence of car accidents (risk x1.5), and hip fractures (risk x 1.8) Addiction, the biggest problem, can usuallyīe avoided by keeping the dose to 0.5 mg/day or less (see discussion below). Lorazepam and clonazepam are a particularly useful agents when treating dizziness because of Memory, increased risk of falling, and possibly impaired vestibular compensation are In small doses, these drugs are extremely useful. There are differential effects across benzodiazepines on Gaba-A receptor subtypes. They increase the affinity of chloride channel opening (Soto et al, 2013). They generally are not toxic, in the sense that they generally do not damage organ systems, but also generally are associated with addiction and tolerance.īenzodiazepines are GABA modulators, acting centrally to suppress vestibular These drugs are largely used to treat anxiety, but also are used to induce sleep, and a variety of other purposes largely involving suppression of the nervous system. It is important to realize that in situations like this, there will be many different opinions.Ĭommonly prescribed benzodiazepines include diazepam (Valium), lorazepam (Ativan), Clonazepam, alprazolam (Xanax) and many others. Hain, who is a clinician who treats dizziness. Much of this page involves opinions of the author, Dr. The bottom line is that there is little experimental data, and that current dogma (not well substantiated) is that benzodiazepines suppress vestibular responses and also suppress compensation.īefore beginning, lets acknowledge that benzodiazepines are addictive substances, and are a source of considerable passion on both sides of the issue regarding their utility for many purposes. The purpose of this page is to review current evidence regarding the effects of benzodiazepines on vestibular function. The benzodiazepines are a family of sedating medications used both for treatment of anxiety and vertigo. Benzodiazepines in dizziness - what is the data ? Timothy C.