Benzodiazepines and z-drugs - between treatment effectiveness and the risk of addiction

CABAJ, Justyna, BARGIEŁ, Julia and SOROKA, Ewelina. Benzodiazepines and z-drugs - between treatment effectiveness and the risk of addiction. Journal of Education, Health and Sport. 2023;46(1):468-480. eISSN 2391-8306. https://dx.doi.org/10.12775/JEHS.2023.46.01.032 https://apcz.umk.pl/JEHS/article/view/45298 https://zenodo.org/record/8290351 The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of 17.07.2023 No. 32318. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences). Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 17.07.2023 Lp. 32318. Posiada Unikatowy Identyfikator Czasopisma: 201159. Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu). © The Authors 2023; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 27.07.2023. Revised:21.08.2023. Accepted: 28.08.2023. Published: 30.08.2023. BENZODIAZEPINES AND Z-DRUGS - BETWEEN TREATMENT EFFECTIVENESS AND THE RISK OF ADDICTION Justyna Cabaj Student Scientific Circle at the II Department of Psychiatry and Psychiatric Rehabilitation https://orcid.org/0000-0002-1394-0638 Julia Bargieł Student Scientific Circle at the II Department of Psychiatry and Psychiatric Rehabilitation https://orcid.org/0000-0002-1388-8243 Ewelina Soroka II Department of Psychiatry and Psychiatric Rehabilitation https://orcid.org/0000-0001-6909-2749 Abstract Benzodiazepines (BZDs) and Z-drugs are commonly prescribed medications for anxiety and sleep disorders. This review examines their efficacy, associated risks, and alternative treatment options. BZDs enhance the activity of gamma-aminobutyric acid (GABA), reducing anxiety, while Z-drugs selectively target GABA-A receptors' alpha-1 subunits for sedative effects. Despite their effectiveness, both drug classes carry the risk of addiction, physical and psychological dependence, and withdrawal symptoms. Side effects, such as drowsiness, dizziness, and cognitive impairment, are also associated with their use. Recent studies indicate that chronic use of BZDs and Z-drugs may lead to cognitive impairment and an increased risk of dementia in older adults. Furthermore, individual factors, dosage, duration of use, and drug interactions can affect their efficacy. Prescribing trends show a decline in benzodiazepine prescriptions and an increase in Z-drug use due to perceived safety advantages. However, evidence suggests that Z-drugs carry similar risks of adverse effects and addiction potential as benzodiazepines. Healthcare professionals should carefully assess patients before prescribing these drugs and monitor their use to prevent dependence and addiction. Brief interventions, patient education, drug withdrawal support, and cognitive behavioral therapy have shown effectiveness in reducing long-term benzodiazepine and Z-drug use. Alternative treatments, including cognitive behavioral therapy and relaxation techniques, should be considered, particularly for patients with a history of addiction or those at high risk of addiction. In conclusion, the risk of addiction, withdrawal symptoms, and adverse effects associated with benzodiazepines and Z-drugs necessitates cautious prescribing and the exploration of alternative treatment options. Keywords : benzodiazepines, Z-drugs, insomni