Pre-Med (Anti-Anxiety Pills) Benzodiazepines or “Benzos”

In dentistry, the most commonly prescribed drugs for anxiety belong to the “benzodiazepine” family. You’ve probably heard of them by their trade names – Valium, Halcion, Xanax, or Ativan.  Benzos directly and efficiently decrease anxiety by binding with receptors in the brain which tone down activity in those parts of the brain responsible for fear. Benzodiazepines can have sedative-hypnotic or anti-anxiety effects.

Sedative-hypnotic drugs induce a calming effect, including drowsiness (“sedation”). In higher doses, they induce a state resembling physiological sleep (“hypnosis”).  Anti-anxiety drugs act primarily to relieve anxiety and make you feel calm.  While all benzodiazepines act as sedatives AND anti-anxiety drugs, some are more targeted at brain areas which control sleep and wakefulness, while others are more specifically targeted at brain areas which control emotions, such as fear. The classification of whether a benzodiazepine is sedative-hypnotic or anti-anxiety is to some extent an arbitrary one, as the boundaries are quite fluid. As a rule of thumb, in higher doses benzos act like sedatives and may promote sleep, while in lower doses, they simply reduce anxiety without sedation.

Benzodiazepines are Central Nervous System (CNS) depressants (for example, there can be a decline in blood pressure and breathing – which is good, because if your heart isn’t racing, you’ll feel calmer). They should NOT be mixed with other CNS depressants such as alcohol. Don’t self-medicate and stick to the dose your dentist or doctor recommends (which may be a higher dose than specified on the drug package insert. Reason being that the package inserts recommend a dose to induce sedation or sleep in a non-stress situation such as the home environment). It IS possible to overdose on these things, and overdoses could lower your breathing to dangerously low levels, which could result in coma or even death.

In case this sounds scary – unless you make a deliberate attempt to overdose, it’s extremely unlikely for any dangerous symptoms to develop. The reason why benzos are so widely used is precisely because they’re safe. People for whom benzos have worked well describe them as “working wonders”, as having a calming and relaxing effect, or as making you feel “out of it”. Giddiness, confusion and saying silly things are also common. Benzos may make you forget large parts of what happened while you were under their influence, which can be handy if you don’t want to remember very much! However, this effect does not happen with everyone.  These medications effect different people in different ways.

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