Benzodiazepines are a class of psychoactive agents which bind to the GABA receptor of the brain, causing the receptor to become more sensitive to activation by naturally occurring gamma-aminobutyric acid (GABA). In the late 1950s Leo Sternbach accidentally discovered chlordiazepoxide (brand name Librium), the first of many of this drug category found to have potential benefit for anxiety, insomnia, muscle spasm, and seizures. Discovered much later, “Z drugs” – named that way because most generic names begin with the letter “Z” – are non-benzodiazepine compounds which also affect the GABA receptor but have a more favorable effect on sleep architecture compared to the benzodiazepines.
These substances have been used over many years, and indeed by 1977 benzodiazepines were the most prescribed class of medications in the world. Even today, however, their apparent benefit for the short term has led to long-term use in large numbers of individuals, a practice that has been challenged. Benzodiazepine use can result in serious adverse reactions, which have been well described, but are often not taken seriously as evidenced by the lack of knowledge, informed consent, and ability to respond to patient concerns by prescribers. Indeed it has taken a crisis – the prominent role benzodiazepines have had in the opioid overdose epidemic – to redirect our attention to these medications.
Niravam Xanax Xanax XR
Approved on 4 week study
Discovered 1957, marketed 1960
Tranxene Tranxene SD Tranxene-T-Tab
Klonopin Klonopin wafers
Approved on 9 week & 6 week trials in panic disorder
Launched in 1963
Approved on the basis of a 2 week study.