Estazolam belongs to the group of drugs - benzodiazepines. It is used in psychiatry, neurology and sometimes by GPs. Benzodiazepines are medications that arouse controversy among doctors. The physician should decide on the legitimacy of their use, exercising caution during treatment. Patients using estazolam or other benzodiazepines should be under more medical supervision due to the frequent development of addiction to these drugs. How to dose estazolam and what are the side effects?

Effects of estazolam

Estazolam, like all benzodiazepines, increases the effects of the GABA neurotransmitter (gamma-aminobutyric acid). By binding to the benzodiazepine receptor, they cause the influx of Cl- ions into the interior of neurons and hyperpolarization of the interior of the cell, followed by inhibition of the neurons' activity. The action of benzodiazepines is due to their potentiation of GABAergic transmission in brain structures such as the cerebral cortex, hippocampus, cerebellum, thalamus and hypothalamus.

Estazolam works:

  • relieving anxiety,
  • calming,
  • sleeping.

This substance shortens the time of falling asleep. Fewer cases of waking up or prematurely waking up have been reported in patients taking this drug. Estazolam has little anticonvulsant activity compared to other benzodiazepines and is therefore not used to treat seizures. It slightly reduces skeletal muscle tension.

The overall action of benzodiazepines is described as depressing the nervous system, ie slowing down its action. Thanks to this, the patient is calmer, he feels drowsy and sometimes even relaxed after taking it. Benzodiazepines are fast-acting drugs, which is their very important advantage, especially in the treatment of anxiety attacks.

Estazolam is an intermediate-acting benzodiazepine. This allows the patient to take it once a day. The risk of retrograde amnesia (the patient cannot remember the last few hours) or excessive sedation is reduced by taking the drug at bedtime. Then the patient does not feel these problematic symptoms so acutely.

Indications for the use of estazolam

The indication for the administration of estazolam is the short-term treatment of severe sleep disorders.The best results are achieved with estazolam therapy in combination with antidepressants and psychotherapy. This medication is also given in the event of panic attacks and agitation.

In the treatment of anxiety disorders, benzodiazepines in some situations bring better results than antidepressants. We are talking about patients who:

  • suffer from anxiety disorders with severe panic attacks. In the case of generalized anxiety disorder or social anxiety disorder, estazolam can be used in combination with antidepressants and psychotherapy,
  • require rapid intervention to alleviate symptoms,
  • have already been treated with antidepressants but they have been unsuccessful or have experienced many side effects during treatment,
  • do not tend to have an interview with psychoactive substances.

Estazolam is not suitable for treatment:

  • post-traumatic stress disorder,
  • obsessive-compulsive disorder,
  • depression with anxiety.

Indications for the use of benzodiazepines in the treatment of insomnia are severe states and situations of sleep deterioration associated with a highly stressful event / life change. In addition to the hypnotic effect, the patient will be calmer. Long-term treatment of insomnia with benzodiazepines is not very effective and is not recommended.

Dosage of estazolam

Estazolam comes in tablets of 2 mg. Most often, the doctor prescribes taking one tablet or half a tablet, 30 minutes before bedtime.

The situation is slightly different in the case of elderly patients. In this group of patients it is recommended to reduce the dose by half. This is because of the increased risk of side effects. Benzodiazepines can accumulate in the body causing excessive sedation, especially in the elderly, as such patients may have reduced kidney or liver function.

Estazolam should not be used in children and adolescents under 18 years of age.

Estazolam should be used for the shortest possible time in the smallest possible dose producing a therapeutic effect. In some cases it is reasonable to continue the treatment even after 2 weeks of treatment, but this decision should not be made without reassessing the patient's he alth.

Treatment of anxiety disorders may extend the duration of treatment.

Contraindications to the use of estazolam

Do not take estazolam if you have:

  • hypersensitivity to estazolam, other benzodiazepines or excipients in the tablet,
  • respiratory failure of any etiology,
  • sleep apnea,
  • disturbance of balance or disturbance of consciousness, dizziness,
  • porphyria or myasthenia gravis,
  • alcohol poisoning or intoxication with drugs that inhibit the central nervous system.

Precautions when using estazolam

It should be remembered that therapy with estazolam and other benzodiazepines is characterized by a decrease in effectiveness over time. The longer the therapy lasts, the less sensitive the patient is to the effects of estazolam and the greater the risk of the patient becoming addicted to this drug. Addiction should not be confused with dependence.

Dependence is the state of the body's physiological adaptation to taking estazolam. The central nervous system adapts to a given psychoactive substance. Due to the dependence of the nervous system on the constant intake of estazolam, its sudden withdrawal may cause withdrawal symptoms.

A patient may develop tolerance to estazolam during treatment. This means that in order to obtain the same therapeutic effect, the dose of the drug should be increased. Benzodiazepine dependence is a condition in which the patient has a strong desire to take the substance and is determined to get it as soon as possible.

It is important that the patient is monitored by a physician if they are taking benzodiazepines. Frequent questions about the patient's mental state and examining their relationship to the drug taken are very important. The doctor should not decide to extend the prescription without examining and talking to the patient. Similarly, you should not write out a prescription for a large supply of medication.

In case of abrupt discontinuation, especially after long-term therapy, withdrawal symptoms may occur in the form of

  • headaches,
  • muscle aches,
  • increased anxiety,
  • tension, excitement, confusion,
  • sleep disorders,
  • irritability.

These are the opposite symptoms to estazolam and other benzodiazepines alone. These symptoms should not be taken as a sign of the patient's deterioration and a decision should be made to restart estazolam in therapy. Withdrawal symptoms are because your nervous system has become accustomed to the medicine you are taking and usually disappear within 2 weeks.

After abrupt discontinuation, a rebound effect may also occur, i.e. an increase in symptoms that initially caused the initiation of treatment. In order to avoid both of these conditions, the drug should be withdrawn gradually. The physician should decide on a drug discontinuation strategy and discuss this carefully with the patient.

Remember to carefully combine estazolam with other drugs that depress the nervous system. Such drugs are:

  • neuroleptics,
  • antipsychotic drugs,
  • sedatives,
  • sleeping pills,
  • antidepressants,
  • antiepileptic drugs,
  • narcotic pain medications,
  • anesthetics,
  • sedative antihistamines,
  • Skeletal muscle relaxants.

You should not use estazolam during pregnancy unless your doctor has recommended such treatment. Estrazolam should not be used while breastfeeding.

Side effects of estazolam

The occurrence of side effects depends on the dose and individual sensitivity of the patient. Usually, most side effects occur in the first 2 weeks. Estazolam is a relatively safe drug and rarely causes side effects when used as prescribed.

The most common side effects are paradoxical reactions (restlessness, insomnia, aggression and hyperactivity), they usually affect the elderly taking estazolam, headache, dizziness, confusion, somnolence, nausea, stomach discomfort, dry mouth .

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