What Factors Affect a Sufficient Benzodiazepine Dosage?

Maggie J. Hall

Many factors affect benzodiazepine dosage including accompanying medications, the method of administration, and the health of the patient. Physicians usually prescribe the medications based on individual need, taking into consideration the specific requirements and condition of the patient. This group of medications produces a calming effect, and benzodiazepine side effects include dizziness, sedation, and a lack of physical coordination.

Benzodiazepine dosage depends upon whether it is administered orally or by IV.
Benzodiazepine dosage depends upon whether it is administered orally or by IV.

Anxiety, seizures, and insomnia can treated with benzodiazepines, which bind to neurorecptors in the central nervous system and inhibit various neurotransmitters. Taking benzodiazepines with other drugs that affect the central nervous system compounds the effects of the medication, which may require benzodiazepine dosage adjustment in patients who take antipsychotic or seizure medications. Individuals should exercise caution when taking benzodiazepines with antihistamines and barbiturates and should not combine benzodiazepines with alcohol.

Benzodiazepine is usually only prescribed on a short-term basis, as it can quickly become habit forming.
Benzodiazepine is usually only prescribed on a short-term basis, as it can quickly become habit forming.

Benzodiazepine dosage varies depending on whether the patient receives the medication by orally, intramuscularly, or intravenously (IV). The body does not absorb and circulate oral medications as quickly as medications that enter the bloodstream immediately through an IV. Benzodiazepines that do not immediately bind to receptor sites accumulate in the fatty tissues of the central nervous system and the rest of the body. Patients with lower levels of body fat than normal may experience an increase in side effects because of greater amounts of medication circulating in the bloodstream. Leaner patients require a lower benzodiazepine dosage than comparably sized patients with more fat tissue.

Patients with kidney or liver impairment are not easily able to metabolize and eliminate medications from, which increases blood levels of benzodiazepines. These patients experience therapeutic effects from lower dosages of benzodiazepines. Likewise, the elderly often exhibit decreased ability to metabolize or eliminate medications from the body. An effective benzodiazepine dosage in an elderly patient may be one third to one half lower than that of younger patients. Benzodiazepine side effects in the elderly often include confusion or over-sedation.

Physicians usually prescribe benzodiazepines for anxiety or as a sedative on an intermittent or short-term basis, as the medications typically become habit forming. Abrupt cessation of the medication induces benzodiazepine withdrawal with symptoms that include abdominal cramping, behavioral disorders, and convulsions. Patients might also have hallucinations, exhibit psychotic behavior, or have seizures. Depressed patients who use benzodiazepines may experience exacerbation of symptoms that include suicidal thoughts. Patients with depression, anxiety, or panic disorder symptoms may require a reduction in benzodiazepine dosage and close supervision.

Individuals should only use benzodiazepines under the close supervision of a physician. Benzodiazepines are safe for appropriately diagnosed patients which does not include use by pregnant women or women planning to become pregnant. Research indicates that benzodiazepines can cause a variety of birth defects as well as the death of unborn children. Women planning on breastfeeding should be equally cautious.

Benzodiazepines should never be combined with alcohol.
Benzodiazepines should never be combined with alcohol.

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