Similarly, Iakovidou-Kritsi et al. We may never get back what we lost but we are here to continue the fight. Aristotle Univ Med J. That said I do honestly believe a handful of people can benefit from long term responsible benzo use. It was concluded that the immune system and blood vessels can be adversely affected by sub-chronic administration of alprazolam to a greater extent than by clonazepam, and these toxic effects are aggravated by stress.
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This lesson will discuss 2 benzodiazepines: We will talk about why both medications are used, comparing and contrasting how they work, effectiveness, side effects, and safety. A Treatment for Anxiety Pounding heart, sweaty palms, racing heart. Anxiety is a common reason for taking benzodiazepines. The Whys and Hows In general, benzodiazepines work by affecting the brain's neurotransmitters chemicals released to aid communication between nerves in the brain.
There are differences in how Klonopin and Xanax work even though they are both benzodiazepines. Why Use Xanax or Klonopin? Xanax is prescribed for the treatment of panic and anxiety disorders. Xanax works by enhancing chemicals that calm the brain, essentially re-balancing chemicals that can become unbalanced in moments of anxiety. Klonopin is used for panic disorders as well, but may also be effective in treating seizures, epilepsy, and insomnia.
Klonopin works similarly to Xanax, but it does so in a slower, gentler way. Dose Differences In comparing the doses, 0. Xanax tablets Klonopin tablets Effectiveness and how long they last The effects of Klonopin last longer than the effects of Xanax in the body, which means that Klonopin does not need to be taken as frequently. Xanax is referred to as an intermediate-acting agent. It takes effect in minutes, reaches peak concentrations within 1 to 2 hours, and its effects can last up to 4 to 6 hours.
Klonopin is referred to as a long-acting agent. Its effect may not be felt for 1 to 4 hours, although speed of absorption depends on the person. Its effect may last up to 12 hours. Xanax and Klonopin compared In general, and depending on the patient's specific needs, Xanax is more ideal for use on an as-needed basis, and Klonopin is better for long-standing anxiety.
Side Effects Both Klonopin and Xanax are not without side effects. Want to learn more? Select a subject to preview related courses: Other potential side effects common to both medications include: Drowsiness, dizziness, fatigue, blurry vision, coordination or balance problems, dry mouth, nausea or vomiting, seizures Side effects that are more common to one specific medication are: Xanax - depression or suicidal thoughts Klonopin - hallucinations, confusion, headaches Safety We have already talked about dependence, a risk with both Xanax and Klonopin, especially when they are taken frequently and at high doses.
Dependence involves tolerance - needing more of a medication to get the same result. Lesson Summary When comparing the two benzodiazepines , clonazepam Klonopin and alprazolam Xanax , we see that they both affect neurotransmitters in the brain, increasing levels of the calming chemical GABA gamma-aminobutyric acid.
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To learn more, visit our Earning Credit Page Transferring credit to the school of your choice Not sure what college you want to attend yet? Browse Articles By Category Browse an area of study or degree level. You are viewing lesson Lesson 6 in chapter 3 of the course:. Overview of Benzodiazepine Drugs. Alternative Medicine for Mental Browse by Lessons Foliated Rock: Help and Review Water Balance: Histopathological findings of the same group Group VI supported the previous results.
Severe depletion of the white pulp lymphocytes and extensive hemorrhages in the red pulp with hemosiderosis and degenerated megakaryocytes were noticed on examination of spleen sections. Focal replacement of subcapsular follicles of the lymph nodes by reticular cells and macrophages was also detected Figure 6 -c. Furthermore, thymus glands showed marked edema and congestion with few erythrocyte and leukocyte infiltrations Figure 6 -d.
Eosinophilic vasculitis was evident on examination of aortic sections with thick tunica media. Eosinophils and round cell infiltrations in the tunica adventitia were also noticed, as shown in Figure 6 -e. Benzodiazepines BZPs are widely used drugs as tranquilizers, anticonvulsants and in various other indications as light anesthesia and skeletal muscle relaxation.
However, not all benzodiazepines have been tested for their immunotoxic effects Huemer et al. In the current study two commonly prescribed BZPs clonazepam and alprazolam were selected to study their immunologic and vascular toxic potential. IL-2 is necessary for the maturation of thymus lymphocytes, facilitation of immunoglobulin production made by B cells, and the differentiation and proliferation of natural killer cells Malek, ; Waldmann, Moreover, it was observed that small numbers of sheep red blood cells SRBC markedly augmented the proliferation of T lymphocytes activated by antigens or mitogens.
This effect occurred with as few as one SRBC per T lymphocyte and with intact or osmotically lysed red cells. After 4 weeks of clonazepam and alprazolam administration, more pronounced immunologic and vascular toxic effects were demonstrated in stressed than in non-stressed adult male albino rats. These toxic changes were significantly expressed in the immunologic parameters as neutrophils, lymphocytes, anti-SRBC, and IL-2 especially in alprazolam-treated stressed rats , supported by the histopathological findings as depletion of lymphocytes from the spleens, lymph nodes and thymuses, congestion, edema, hemosiderosis, inflammatory cells infiltration, large vessels eosinophilic infiltration, vasculitis, plaques and degeneration.
Our results are in accordance with those of Massoco and Palermo-Neto and Huemer et al. It has been substantiated that stressful stimuli in man as well as in animals lead to suppression of the humoral and cellular components of the immune system. The central nervous system is known to be involved in the regulation of stress-induced immune responsiveness Yin et al. The results of the present study also showed that restraint stress produced an inhibition of SRBC antibody, that was worsened by the administration of either clonazepzm or alprazolam with inhibition of IL In , Chang et al.
Moreover, long-lasting depression of lymphocytic proliferation has been described in offspring of rats exposed to either diazepam or clonazepam during pregnancy Schlumpf et al. Lymphocytic depletion, similar to that observed in the current study, was noticed in both red and white pulp of the spleen in rats treated with diazepam 0. Moreover, the observed hemosideriosis in spleens of alprazolam-treated stressed rats may be attributed to increased erythrophagia Pacheco and Santos, Several reports identified BZP peripheral type binding sites PBR in endocrine steroidogenic tissues, organs and cells of the immune system, such as macrophages and lymphocytes.
In the current study, immune and vascular toxic effects might be related to cortisol production. Glucocorticoid hormones are known for their potent immunosuppressive and anti-inflammatory properties. On the other hand, restraint stress was found to induce corticosterone secretion Li et al. Elevated endogenous corticosteroid levels were linked to reduced spleen cellularity and B cell function in mice Shi et al.
Moreover, they produced neutrophilic leukocytosis, lymphopenia and reduced anti-SRBC titer and IL-2 level, a picture similar to that detected in the present study Anderson et al. Alprazolam was tested previously for its effects on corticosteroid production. Chronic administration of alprazolam for 29 days to hamster rats resulted in increased cortisol and total glucocorticoid levels. It was concluded that alprazolam had a stimulative effect on cortisol production Arvat et al. On the other hand, clonazepam was shown to counteract the effect of stress on cortisol level Chevassus et al.
In this context, the cytokine system emerges as a good candidate. Calcium release appears to be essential for T cell activation, cytokine synthesis, and proliferation. Clonazepam was found to have a strong binding capacity to peripheral benzodiazepine receptors in rat aortic smooth muscles compared to other benzodiazepines. These binding sites were concentrated in the mitochondria Cox et al.
Peripheral benzodiazepine receptors bind with high affinity to cholesterol and transport it across the mitochondrial membrane Papadopoulos et al. This may explain the appearance of foam cells and degeneration of smooth muscle observed in the aortae of clonazepam treated rats. This action was accentuated by dexamethasone administration. Furthermore, an in vitro study carried out by Saha et al.
Similarly, Iakovidou-Kritsi et al. It seems relevant to point out that alprazolam has a triazolo- ring, and a — CH 3 — group that could interact with DNA as an alkylating agent Brambilla et al. In contrast to the present results, Freire-Garabal et al. Clonazepam and alprazolam appeared to modulate immune responsiveness in both non-stressed and stressed animals, albeit in a different manner, and these effects were mediated via alteration of the structure of organs of the immune system histopathological lesions.
It was concluded that the immune system and blood vessels can be adversely affected by sub-chronic administration of alprazolam to a greater extent than by clonazepam, and these toxic effects are aggravated by stress. Further, the results of the present study raise concern regarding the safety of benzodiazepine administration over long periods. National Center for Biotechnology Information , U. Journal List Interdiscip Toxicol v.
Published online Sep. Elmesallamy , 1 Marwa A. Abass , 1 Nahla A. Ahmed Refat , 2 and Amal H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC.
Abstract Benzodiazepines belongs to one of the most commonly used anxiolytic and anticonvulsant drugs in the world. Introduction Recent studies have found that stress plays a role in the etiology of many diseases. Material and methods Drugs Clonazepam was obtained from Roche, F. Experimental design Forty-two adult male albino rats of g average weight were brought from the Animal House, Faculty of Medicine, Zagazig University, divided into 6 groups and caged under standardized environmental conditions.
Twelve rats were equally subdivided into Ia: Negative control non-stressed rats, received only the regular diet and tap water to determine the normal values of the performed tests. Positive control non-stressed rats, gavaged daily with 1 ml of distilled water. Six stressed rats, were submitted to daily restraint stress at room temperature. Six non stressed rats were given daily oral dose of Clonazepam 0. Six stressed rats were given daily oral dose of Clonazepam 0. Six non-stressed rats were given daily oral dose of Alprazolam 0.
Six stressed rats were given daily oral dose of Alprazolam 0. Restraint stress procedure It was done by the procedure described by Glavin et al. WBCs count and differential count Total leukocyte count was determined by following the method described by Chanarin et al. Cell-mediated immune response It was assayed through determination of the cytokine Interleukin-2 IL Control rat group I: Stressed non-treated rat group II: Comparison of the mean values for each parameter assessed in the different study groups LSD test.
Clonazepam-treated unstressed rat group III: Clonazepam-treated stressed rat group IV: Alprazolam-treated unstressed rat group V: Alprazolam-treated stressed rat group VI: Discussion Benzodiazepines BZPs are widely used drugs as tranquilizers, anticonvulsants and in various other indications as light anesthesia and skeletal muscle relaxation. Regulation of cytokine and cytokine receptor expression by glucocorticoids. The effect of dexamethasone on some immunological parameters in cattle.
The inhibitory effect of alprazolam, a benzodiazepine, overrides the stimulatory effect of metyrapone-induced lack of negative cortisol feedback on corticotrophin secretion in humans. J Clin Endocrinol Metabol. Theory and practice of histological techniques. Edinburgh, London, Melbourne, New York: Churchill Livingstone Press; Pancytopenia associated with clonazepam. Genotoxicity and carcinogenicity studies of benzodiazepines.
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J Pharmacol Exp Ther. Effects of different doses and schedules of diazepam treatment on lymphocyte parameters in rats. Acute stress enhances while chronic stress suppresses cell- mediated immunity in vivo: Cytogenetic activity of newly synthesized 1,5-benzodiazepines in normal human lymphocyte cultures.
Genet Test Mol Biomarkers. Effects of alprazolam on T-cell immunosuppressive response to surgical stress in mice. Enigma of the peripheral benzodiazepine receptor. Genetic toxicology of four commonly used benzodiazepines: Mut Res Rev Gen Tox. Restraint stress in biomedical research: Comprehensive Toxicology, 2 nd ed. Methods to assess immunotoxicity; pp. Monoallelic expression of the interleukin-2 locus. Diazepam leads to enhanced severity of orthopoxvirus infection and immune suppression.
In vitro genotoxicity of two widely used benzodiazepines: