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Long-acting benzodiazepines with long-acting active metabolites, such as diazepam and chlordiazepoxide, are often prescribed for benzodiazepine or alcohol withdrawal as well as for anxiety if constant dose levels are required throughout the day. Shorter-acting benzodiazepines are often preferred for insomnia due to their lesser hangover effect.
Symptoms. Effects of long-term benzodiazepine use may include disinhibition, impaired concentration and memory, depression, [ 19][ 20] as well as sexual dysfunction. [ 6][ 21] The long-term effects of benzodiazepines may differ from the adverse effects seen after acute administration of benzodiazepines. [ 22]
Some benzodiazepines have long-acting active metabolites, such as diazepam and chlordiazepoxide, which are metabolised into desmethyldiazepam. Desmethyldiazepam has a half-life of 36–200 hours, and flurazepam, with the main active metabolite of desalkylflurazepam, with a half-life of 40–250 hours.
Diazepam is a long-acting "classical" benzodiazepine. Other classical benzodiazepines include chlordiazepoxide, clonazepam, lorazepam, oxazepam, nitrazepam, temazepam, flurazepam, bromazepam, and clorazepate. [100] Diazepam has anticonvulsant properties. [101]
The risk and severity of withdrawal are increased with long-term use, use of high doses, abrupt or over-rapid reduction, among other factors. Short-acting benzodiazepines such as lorazepam are more likely to cause a more severe withdrawal syndrome compared to longer-acting benzodiazepines. [13]
Clorazepate is a long-acting benzodiazepine drug. [10] Clorazepate produces the active metabolite desmethyl-diazepam , which is a partial agonist of the GABA A receptor and has a half life of 20–179 hours; a small amount of desmethyldiazepam is further metabolised into oxazepam .
Clonazepam, sold under the brand names Klonopin and Rivotril, is a medication used to prevent and treat anxiety disorders, seizures, bipolar mania, agitation associated with psychosis, obsessive–compulsive disorder, and akathisia. [ 11] It is a long-acting [ 12] tranquilizer of the benzodiazepine class. [ 11]
Nitrazepam is a long-acting benzodiazepine with an elimination half-life of 15–38 hours (mean elimination half-life 26 hours). [12] Residual "hangover" effects after nighttime administration of nitrazepam such as sleepiness, impaired psychomotor and cognitive functions may persist into the next day, which may impair the ability of users to ...