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Thursday, November 26, 2020

Sleeping pills and insomnia

What do Valium, Serepax, Mogadon and Normison all have in common? If you guessed ‘they are all benzodiazepines, highly addictive and commonly prescribed medications for insomnia’, then you are correct.

How common are benzodiazepines?

According to official figures from NPS MedicineWise, around 6 million prescriptions for benzodiazepines were dispensed in 2018, although once you include off-label and hospital scripts, the true figure is likely to be much higher. 

Even though the problems associated with benzodiazepines are well known they are still routinely prescribed without warnings that they are highly addictive and should only be used for short term use.

How do they work?

Benzodiazepines depress the central nervous system and temporarily slow the workings of your brain, briefly masking symptoms of anxiety or insomnia. Taking these medications for even a few days can lead to what’s called ‘tolerance’, where you need a higher dose to achieve the same relief, and without the medication your symptoms are worse than before you started taking the medication. It can be a slippery slope to high dosages and complete dependency.

Withdrawal

The side effects that occur when you stop taking benzodiazepines can be brutal and may include insomnia and anxiety as well as headaches, aching muscles, dizziness, tremors, nausea, vomiting, stomach pains, delusions, hallucination, paranoia and seizures.

It is absolutely possible to stop taking benzodiazepines but it must be done gradually and with expert medical supervision.

Sadly, benzodiazepines are also one of the most commonly misused pharmaceuticals. According to the Royal Australian College of GPs (RACGP), approximately half (48.8%) of all drug-related deaths are associated with benzodiazepines.  

What to do if you can’t sleep

If you’re currently using medication for chronic insomnia, talk to your GP and make a plan. The RACGP recommends the best initial treatment for chronic insomnia is Cognitive Behaviour Therapy (CBT), so hopefully you leave your GP’s office with a referral to a psychologist, not a prescription for pills. 

In my practice, I have found acupuncture and herbal medicine to be especially effective for insomnia. Herbs are non-addictive and, when prescribed accurately, treat the cause as well as the symptoms of insomnia, so once normal sleep is restored you no longer need to take them. Generic ‘off-the-shelf’ herbal remedies can sometimes work but given the many different reasons for insomnia, individually prescribed combinations tend to work much better.

Acupuncture is a well-known and evidence-based treatment for stress. I often describe it as ‘training wheels’ for a nervous system that has to re-learn how to switch off and unwind. It might seem counterintuitive that sticking needles in someone would cause them to relax, but talk to someone who’s tried it at they’ll tell you how powerfully it can restore an agitated nervous system to a state of calm and ease.

Editor’s note: Our rotating wellbeing and fitness columns provide advice that is general in nature. Please always refer to your preferred health professional for advice suited to your personal healthcare requirements.

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