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Benzodiazepine dependence or benzodiazepine addiction is when one has developed one or more allison chains porn either tolerancewithdrawal symptomsdrug seeking behaviors, such as continued use despite harmful effects, and maladaptive pattern of substance use, according to the DSM-IV. In the case of benzodiazepine dependence, however, the continued use seems to be associated with the avoidance of unpleasant withdrawal reaction rather than from the pleasurable effects of the drug.

Addiction, or what is sometimes referred to as psychological dependence, includes people misusing or craving the drug not to relieve withdrawal symptoms, but to experience its euphoric or intoxicating effects. It is important to distinguish between addiction and drug abuse of benzodiazepines and normal physical dependence on benzodiazepines. The increased GABA A inhibition caused by benzodiazepines is counteracted by the body's development of tolerance to the drug's effects; the development of tolerance occurs as a result of neuroadaptations, which result in decreased GABA inhibition and increased excitability of the glutamate system; these adaptations occur as a result of the body trying to overcome the central nervous system depressant effects of the drug to restore homeostasis.

When benzodiazepines are stopped, these neuroadaptations are "unmasked" leading to hyper-excitability of the nervous system and the appearance of withdrawal symptoms. Therapeutic dose dependence is the largest category of people dependent on benzodiazepines. These individuals typically do not escalate their doses to high levels or abuse their medication.

Smaller groups include patients escalating their dosage to higher levels and drug misusers as well. It is unclear exactly how many people illicitly abuse benzodiazepines. Tolerance develops within days or weeks to the anticonvulsant, hypnotic muscle relaxant and after 4 months there is little evidence that benzodiazepines retain their anxiolytic properties.

Some authors, however, disagree and feel that benzodiazepines retain their anxiolytic properties. Dependence boondocks porn pics misuse of benzodiazepines have been of concern since Numbers of benzodiazepine prescriptions have been declining, due primarily to concerns of dependence.

In the short term, benzodiazepines can be effective drugs for acute anxiety or insomnia. With longer-term use, other therapies, both pharmacological and psychotherapeutic, vintage porn babes more effective. This is in part due to the greater effectiveness over time of other forms of therapy, and also due to the eventual development of pharmacological benzodiazepine tolerance. Benzodiazepine dependence is the condition resulting from repeated use of benzodiazepine gay tube porn free. It can include both a physical dependence as well as a psychological dependence and is typified by a withdrawal syndrome upon a fall in blood plasma levels of benzodiazepines, e.

The signs and symptoms of benzodiazepine dependence include feeling unable to cope without the drug, unsuccessful attempts to cut down or stop benzodiazepine use, tolerance to the effects of benzodiazepines, and withdrawal symptoms when not taking the drug. Some withdrawal symptoms that may appear include anxietydepressed mooddepersonalisationderealisationsleep disturbancehypersensitivity to touch and pain, tremorshakinessmuscular aches, pains, twitches, and headache.

The Department of Health substance misuse guidelines recommend monitoring for mood disorder in those dependent on or withdrawing from benzodiazepines. Benzodiazepine dependence is a frequent complication for those prescribed for or using for longer than four weeks, with physical dependence and withdrawal symptoms being the most common problem, but also occasionally drug-seeking behavior.

Withdrawal symptoms include anxiety, perceptual disturbances, distortion of all the senses, dysphoria, and, in rare cases, psychosis and epileptic seizures. Long-term use and benzodiazepine dependence is a serious problem in the elderly. Failure to treat benzodiazepine dependence in the elderly can cause serious medical complications.

This can lead to excessive contact with their doctor. Research has found that withdrawing elderly people from benzodiazepines leads to a significant reduction in doctor visits per year, it is presumed, due to an elimination of drug side-effects allison chains porn withdrawal effects. Tobacco and alcohol are the most common substances that elderly people get a dependence on or misuse. The next-most-common substance that elderly people develop a drug dependence to or misuse is benzodiazepines.

Drug-induced cognitive problems can have serious consequences for elderly people and can lead to confusional states and "pseudo-dementia". Benzodiazepines have also been linked to an increased risk of road traffic accidents and falls in the elderly. The long-term effects of benzodiazepines are still not fully understood tsunade anime porn the elderly or any age group.

Long-term benzodiazepine use is associated with attentional and visuospatial functional impairments. Withdrawal from benzodiazepines can lead to improved alertness and decreased forgetfulness in the elderly. Withdrawal led to statistical significant improvements in memory function and performance related skills in those having withdrawn successfully from benzodiazepines, whereas those having remained on benzodiazepines experienced worsening symptoms, allison chains porn.

People having withdrawn from benzodiazepines also felt their sleep was more refreshing, making statements such as " I feel sharper when I wake up " or " I feel better, more awake ", allison chains porn, or " It used to take me an hour to fully wake up. Tolerance occurs to allison chains porn muscle-relaxant, anticonvulsant, and sleep-inducing effects of benzodiazepines, and upon cessation a benzodiazepine withdrawal syndrome occurs.

This can lead to benzodiazepines being taken for longer than originally intended, as people continue to take the drugs over a long period of time to suppress withdrawal symptoms. Some people abuse benzodiazepines at very high doses and devote a lot of time to doing so, satisfying the diagnostic criteria in DSM IV for substance abuse and dependence.

Another group of people include those on low to moderate therapeutic doses of benzodiazepines who do not abuse their benzodiazepines but develop a tolerance and benzodiazepine dependence, allison chains porn. Tolerance to the anxiolytic effect of benzodiazepines has been clearly demonstrated in rats.

Some authors, however, consider benzodiazepines to be effective long-term; however, it is more likely that the drugs are acting to prevent rebound anxiety withdrawal effects. Tolerance to the anticonvulsant and muscle-relaxing effects of benzodiazepines occurs within a few weeks in most patients. The risk factors for benzodiazepine dependence are long-term use beyond four weeks, use of high doses, use of potent short-acting benzodiazepines, dependent personalities, and proclivity for drug abuse.

Symptom severity is worse with the use of high doses, or with benzodiazepines of high potency or short half-life. Other cross-tolerant sedative hypnotics, such as barbiturates or alcoholincrease the risk of porn channels on xfinity dependence. Tolerance develops rapidly to the sleep-inducing effects of benzodiazepines.

The anticonvulsant and muscle-relaxant effects last for a few weeks before tolerance develops in most individuals, allison chains porn. Tolerance results in a desensitization of GABA receptors and an increased sensitization of the excitatory neurotransmitter system, glutamate such as NMDA glutamate receptors.

These changes occur as a free hairy porn com of the body trying to overcome the drug's effects. Other changes that occur are the reduction of the number of GABA receptors downregulation as well as possibly long-term changes in gene transcription coding of brain cells. The differing speed at which tolerance occurs to the therapeutic effects of benzodiazepines can be explained by the speed of changes in the range of neurotransmitter systems and subsystems that are altered by chronic benzodiazepine use.

The various neurotransmitter systems and subsystems may reverse tolerance at different speeds, thus explaining the prolonged nature of some withdrawal symptoms. As a result of a physical dependence that develops due to tolerance, a characteristic benzodiazepine withdrawal syndrome often occurs after removal of the drug or a reduction in dosage. In normal subjects, increases in growth hormone occurs, whereas, in benzodiazepine-tolerant individuals, this effect is blunted.

Animal studies have shown that repeated withdrawal from benzodiazepines leads to increasingly severe withdrawal symptoms, including an increased risk of seizures; this phenomenon is known as kindling.

The shift of benzodiazepine receptors to an inverse agonist state after chronic treatment leads the brain to be more sensitive to excitatory drugs or la belle porn. Excessive glutamate activity can result in excitotoxicitywhich may result in neurodegeneration.

The glutamate receptor subtype NMDA is well known for its role in causing excito-neurotoxicity. The glutamate receptor subtype AMPA is believed to play an important role in neuronal kindling as well as excitotoxicity during withdrawal from alcohol as well as benzodiazepines. It is highly possible that NMDA receptors are involved in the tolerance to some effects of benzodiazepines.

Animal studies have found that glutamergic changes as a result of benzodiazepine use are responsible for a delayed withdrawal syndrome, which in mice peaks 3 days after cessation of benzodiazepines. This was demonstrated by the ability to avoid the withdrawal syndrome by the administration of AMPA antagonists. It is believed that different glutamate subreceptors, e. NMDA receptors are upregulated in the brain as a result of benzodiazepine tolerance.

AMPA receptors are also involved in benzodiazepine tolerance and withdrawal. Benzodiazepines share a similar mechanism of small penis porn videos with various sedative compounds that act by enhancing the GABA A receptor. Cross tolerance means that one drug will alleviate the withdrawal effects of another. It also means that tolerance of one drug will result in tolerance of another similarly-acting drug.

Benzodiazepines are often used for this reason to detoxify alcohol-dependent patients and can have life-saving properties in preventing or treating severe life-threatening withdrawal syndromes from alcohol, such as delirium tremens.

However, although benzodiazepines can be very useful in the acute detoxification allison chains porn alcoholics, benzodiazepines in themselves act as positive reinforcers in alcoholics, by increasing the desire for alcohol. Low doses of benzodiazepines were found to significantly increase the level of alcohol consumed in alcoholics.

There is cross tolerance between alcoholallison chains porn, the benzodiazepinesthe barbituratesthe nonbenzodiazepine drugs, and corticosteroidswhich all act by enhancing the GABA A receptor's function via modulating the chloride ion channel function of the GABA A receptor.

Neuroactive steroidse. Abrupt withdrawal from any of these compounds, e. Alterations of levels of neuroactive steroids in the body during the menstrual cycle, menopausepregnancy, and stressful circumstances can lead to a reduction in the effectiveness of benzodiazepines and a reduced therapeutic effect.

During withdrawal of neuroactive steroids, benzodiazepines become less effective. Withdrawal symptoms are a normal response in individuals rick ritter porn chronically used benzodiazepines, and an adverse effect and result of drug tolerance.

Symptoms typically emerge when dosage of the drug is reduced. GABA is the second-most-common neurotransmitter in the central nervous system the most common being glutamate [36] [37] snow white and the seven dwarfs cartoon porn and by far the most abundant inhibitory neurotransmitter; roughly one-quarter to one-third of synapses use GABA.

Benzodiazepines cause a decrease in norepinephrine noradrenalineserotoninacetylcholineand dopamine [ citation needed ]. These neurotransmitters are needed for normal memory, mood, muscle tone and coordination, emotional responses, endocrine gland secretions, heart rate, and blood pressure control.

With chronic benzodiazepine use, tolerance develops rapidly to most of its effects, so that, when benzodiazepines are withdrawn, various neurotransmitter systems go into overdrive due to the lack of inhibitory GABA -ergic activity. Withdrawal symptoms then emerge as a result, and persist until the nervous system physically reverses the adaptions physical dependence that have occurred in the CNS.

Withdrawal symptoms typically consist of a mirror image of the drug's effects: Sedative effects and suppression of REM and SWS stages of sleep can be replaced by insomnianightmaresand hypnogogic hallucinations; its antianxiety effects are replaced with anxiety and panic; muscle-relaxant effects are replaced with muscular spasms or cramps; and anticonvulsant effects are replaced with seizures, especially in cold turkey or overly-rapid withdrawal.

Benzodiazepine withdrawal represents in part excitotoxicity to brain neurons. During withdrawal from full or partial agonists, changes occur in benzodiazepine receptor with upregulation of some receptor subtypes and downregulation of other receptor subtypes. Long-term use of benzodiazepines leads to increasing physical and mental health problems, and as a result, discontinuation is recommended for many long-term users.

The withdrawal syndrome from benzodiazepines can range from a mild and short-lasting syndrome to a prolonged and severe syndrome. Withdrawal symptoms can lead to continued use of benzodiazepines for many years, long after the original reason for taking benzodiazepines has passed.

Many patients know that the benzodiazepines no longer work for them but allison chains porn unable to discontinue benzodiazepines because of withdrawal symptoms. Withdrawal symptoms can emerge despite slow reduction but can be reduced by a slower rate of withdrawal. As a result, withdrawal rates have been recommended to be customized to each individual patient. The time needed to withdrawal can vary from a couple of months to a year or more and often depends on length of use, dosage taken, lifestyle, health, and social and environmental stress factors.

Diazepam is often recommended due to its long elimination half-life and also because of its availability in low potency doses. The non-benzodiazepine Z drugs such as zolpidem, zaleplon, and zopiclone should not be used as a replacement for benzodiazepines, as they have a similar mechanism of action and can induce a similar dependence.

The pharmacological mechanism of benzodiazepine tolerance and dependence is the internalization removal of receptor site in the brain and changes in gene transcription codes in the brain.

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