Phenazepam as a drug - side effects, poisoning, consequences of overdose, how long it works

Phenazepam is a tranquilizer from the group of benzodiazepines. In medicine it is used as a sedative, hypnotic, anticonvulsant and muscle relaxant. When consumed, it causes mild euphoria and relaxation, which has become the reason for its use for recreational purposes. The drug is not included in the list of narcotic drugs, but with its long-term use, dependence appears and withdrawal syndrome develops. In case of drug poisoning, symptoms of overdose appear and death may occur.

Effect on the body

The action of Phenazepam, like other benzodiazepines, is based on enhancing the action of GABA (gamma aminobutyric acid), the main inhibitory neurotransmitter of the central nervous system. The increased inhibition of neurons in subcortical formations caused by it determines the main effects of the use of Phenazepam:

sedative;
anxiolytic;
muscle relaxant;
anticonvulsant;
hypnotic.

Phenazepam is the most popular tranquilizer in the internal medicine clinic.
Relieving anxiety, autonomic disorders, normalizing sleep, the drug helps to quickly normalize the patient’s condition in many diseases. For recreational purposes, Phenazepam is taken in increased dosages, which has a negative effect on the body.

Physiological symptoms

When using Phenazepam in large doses, the following negative symptoms are observed:

decreased blood pressure;
tachycardia;
disturbance of appetite and stool;
urinary dysfunction (urinary retention or incontinence);
pale skin;
chills.

From the peripheral nervous system:

slowing of psychomotor reactions;
slurred speech;
unsteady gait;
trembling of limbs;
headache, dizziness.

Psycho-emotional manifestations

The following manifestations are observed from the psyche:

drowsiness;
confusion;
general disorientation;
restlessness;
slurred talkativeness;
unproductive activity.

Mental manifestations are mainly determined by individual tolerance to tranquilizers - in some patients, even therapeutic doses of the drug can cause fainting or severe headache.

Detoxification in hospital

In the hospital, first of all, gastric lavage is performed using a siphon. In this way, you can cleanse the entire stomach without artificially stimulating the vomiting center. After gastric lavage, sorbents (activated carbon, Smecta, white carbon) may be prescribed.

Instead of drinking plenty of fluids in the hospital, infusion therapy with 5% glucose and saline is carried out. This helps remove drug toxins from the liver and kidneys. This way, cleansing occurs faster and symptoms of poisoning or overdose disappear.

The next step is to prescribe specific antidotes to benzodiazepines. These are the following:

Mesocarb;
Flumazenil.

Both drugs must be calculated correctly. If the dosage is incorrect, it can only make things worse.

If possible, in a hospital or special rehabilitation clinics, the blood is purified using an “artificial kidney” device, and the patient is sent for hemodialysis. All methods are based on hardware blood purification; they are relevant for detoxification. Although there is evidence that in case of an overdose of Phenazepam, hemodialysis is ineffective.

It has been established that among all drugs from the benzoidazepine group, Phenazepam is one of the best anxiolytics.
Taken from the scientific article: “The effectiveness of phenazepam as part of complex therapy in patients with anxiety-depressive syndromes.” Authors: M.E. Statsenko, O.E. Sporova, O.A. Talker.

Signs of a drug addict

When taking Phenazepam for recreational purposes, the dose of the drug significantly exceeds the therapeutic dose (4-6 tablets at a time). The clinic for drug intoxication is very similar to the clinic for alcohol intoxication:

disinhibition against the background of high spirits;
unproductive motor activity;
liveliness, talkativeness, slurred, confused speech;
loss of coordination of movements, unsteadiness of gait;
pallor of the skin.

When the effect of the drug ends, the following appear:

lethargy, drowsiness;
severe physical weakness.

These symptoms can vary significantly from person to person, so a final conclusion about tranquilizer addiction can only be made by a narcologist after a laboratory examination.

Harm from drugs

Phenazepam, taken long-term in large dosages, has a negative effect on all somatic systems and organs, as well as on the function of the central nervous system and peripheral nervous system:

from the cardiac system - surges in blood pressure, tachycardia;
from the blood – the number of formed elements in the peripheral blood decreases;
from the gastrointestinal tract - increased salivation, nausea, vomiting, heartburn, unstable stool, possible jaundice;
from the kidneys and liver - the development of failure of these organs;
from the central nervous system and peripheral nervous system - the development of drug dependence, memory impairment, problems with orientation, severe headaches and muscle pain, tremors of the limbs.

Contraindications

Phenazepam has the following contraindications:

myasthenia gravis;
coma;
shocking;
angle-closure glaucoma;
alcohol/drug poisoning;
acute respiratory failure;
severe depression;
first trimester of pregnancy;
lactation;
under 18 years of age;
intolerance to ingredients.

In conclusion, phenazepam is not used to treat high blood pressure. It can only be used if the increase in blood pressure occurs due to psychological factors. However, it should be taken with caution and strictly follow the doctor's instructions.

Consequences of long-term use

In the clinic, Phenazepam is prescribed in minimal dosages for a period of no more than a week. Long-term use of large doses of the drug leads to dysfunction of internal organs, peripheral and central nervous systems:

myocardial dystrophy;
renal failure;
toxic hepatitis;
severe sleep disturbances;
rapid development of mental and physical dependence;
convulsive readiness, muscle twitching,
emotional lability, anxiety, aggressiveness;
instability of attention, inability to assimilate any information;
depression;
polydrug addiction,
suicide.

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General information

The drug phenazepam is a typical tranquilizer. It is used to normalize sleep, combat anxiety, and relieve convulsive syndrome in epilepsy. Fenozepam is available in injection form or in tablets. All central effects of the drug are achieved through stimulation of benzodiazepine receptors.

The effect of the drug extends to the reticular formation, nonspecific centers of the thalamus and the amygdala complex. The muscle relaxant effect is based on the ability to block spinal reflexes. The tranquilizer is well absorbed through the gastrointestinal tract, after which it is metabolized in the liver and excreted by the kidneys.

Phenazepam is available without a prescription. Doctors sometimes prescribe it to improve sleep, relieve anxiety during performances or in extreme situations. The first aid kit always contains Phenazepam in injection form to relieve seizures in epilepsy or damage to the central nervous system.

All drugs from the benzoidazepine group cause sleep lasting up to 6-8 hours. But the longer the sleep, the stronger the drowsiness, fatigue and depression will be during the next day after taking the drug.
Taken from: Pharmacology, tenth edition by D.A. Kharkevich

The drug is not considered a drug, but addiction can develop from it. In addition, with each subsequent dose, to achieve the desired effect, it is necessary to increase the dose. If you increase the dosage without consulting a doctor, this will lead to acute drug poisoning with possible death.

Danger of consumption methods

In the pharmacy chain, Phenazepam is sold in two dosage forms: in tablet form for oral use and in ampoule form for intramuscular and intravenous administration.

Both dosage forms can be used for recreational purposes.
With frequent oral use of large doses of a tranquilizer, all chronic diseases of the gastrointestinal tract are aggravated, in addition, the drug damages the mucous membrane of the digestive tract, causing erosions and ulcers. The most commonly used injection method of administering the drug, which can lead to an overdose of a tranquilizer. In addition, this method of administration often leads to infection (HIV, viral hepatitis, sepsis).

Drug overdose

When using Phenazepam for medicinal purposes, its dosage is 2.5-5.0 mg per day, but if the drug is used for recreational purposes, the dose of the substance taken is 4-6 times higher. Therefore, acute tranquilizer poisoning often occurs.

The main signs of overdose are:

confused, unclear consciousness;
decreased blood pressure;
bradycardia;
decreased number of respiratory movements;
nausea, vomiting, hypersalivation;
tremor of the limbs, sometimes convulsions;
nystagmus.

In case of severe overdose:

shallow irregular breathing;
a sharp drop in blood pressure;
bradycardia with severe forms of arrhythmia;
coma.

Main reasons

The main causes of Phenazepam overdose are:

quickly emerging and rapidly increasing tolerance to the drug;
frequent use of Phenazepam with alcohol to enhance the narcotic effect;
suicide.

First aid

At the first signs of an overdose, it is necessary to call a specialized team. Before the doctor arrives:

if the patient is conscious: rinse the stomach, give enterosorbent (Enterosgel, Smecta);
if there is no consciousness: put the victim on his side, wrap him in a blanket, and if breathing or heartbeat stops, perform indirect cardiac massage and artificial respiration.

Health care

At the prehospital stage:

if the victim is unconscious, rinse the stomach with a thick probe;
Oxygen support is provided and, if necessary, mechanical ventilation;
as detoxification therapy, saline solutions and glucose are administered intravenously;
use cardiotonics to maintain heart function (Dobutrex, Dopamine, Mildrinon);
analeptics to stimulate the respiratory center (caffeine, cordiamine).

Stationary stage:

continue treatment started at the prehospital stage.
the antidote of Phenazepam is administered - Flumazenil - a benzodiazepine receptor antagonist (the use of the antidote is allowed only in a hospital);
carry out drug and hardware (hemosorption, hemodialysis) detoxification.

Consequences of lack of help

In the absence of help in cases of severe poisoning, death may occur as a result of stopping the vasomotor and respiratory centers.

For milder poisonings, the following complications are possible:

cerebellar ataxia;
severe pneumonia;
severe pyelonephritis;
liver dysfunction;
depression.

Lethal dose

The maximum therapeutic dose of Phenazepam is 10 mg; exceeding this dose leads to an overdose, and a single dose of 20 mg or a daily dose of 40 mg leads to death.

How to stop the action (antidotes)

The antidote to Phenazepam is Flumazenil, a benzodiazepine receptor blocker. The drug is allowed to be administered only in a hospital setting, since to correctly calculate its dose, many factors must be taken into account:

state and functionality of the cardiovascular system;
breathing pattern and functionality of the respiratory system;
the presence of convulsive readiness in the patient.

The drug is administered very slowly, since rapid administration causes palpitations, fear, and anxiety.

How to speed up elimination at home

Breeding at home can be hazardous to health. During the rapid release of the drug and its metabolites, rebound syndrome may occur. This means that all inhibitory effects that the drug had will be suppressed by antagonistic mediators. That is, if Phenazepam relaxes the muscles, then if it is abruptly discontinued, cramps may begin. The same applies to sleep and other functions that are affected by tranquilizers.

It is better to limit withdrawal at home to 3-4 procedures and carry it out only in case of an overdose caused by a desire to get drug intoxicated or during a suicide attempt. In other cases, if there are no symptoms of overdose, there is no need to accelerate the elimination of the drug.

Algorithm of actions:

Rinse the stomach. You can do this by drinking plenty of water, up to two liters of water, and then mechanically induce vomiting (press the root of the tongue with two fingers). This procedure must be repeated 2-3 times. They are effective in the first hour and a half after taking the tablets.
Take sorbents. It is recommended to take one tablet of activated carbon per 10 kilograms of body weight. You can do more, there will be no harm from the sorbents.
Drink plenty of fluids to speed up kidney function. This technique is called forced diuresis. Due to heavy drinking, the fluid that is excreted by the kidneys will “pull back” some of the drug metabolites.

If after these procedures lethargy remains and the person is inhibited, you can brew him strong coffee. Caffeine stimulates the nervous system and “unblocks” some of the nerve synapses that inhibit the reaction.

It is better to speed up the elimination of the drug in a hospital setting. Then it is possible to monitor the patient’s general condition and carry out specific therapy with antidotes. In addition, in cases of life-threatening symptoms, emergency medical care can be provided.

Withdrawal syndrome (withdrawal)

Withdrawal syndrome is a severe psychosomatic condition that occurs after stopping taking Phenazepam or reducing the consumed dose.

On the part of the internal organs, vegetative disorders predominate:

hypotension;
fluctuations in body temperature;
hyperhidrosis;
lack of appetite, nausea, vomiting;
trembling of limbs;
difficulty speaking.

From the psycho-emotional sphere:

depression;
anxiety, irritability, turning into aggressiveness;
severe sleep disorders;
increased sensitivity to loud sounds, strong odors, photophobia.

2-3 days after discontinuation of the drug, fibrillary twitching of individual muscle groups begins, and generalized convulsions may develop. The development of psychosis is possible. The duration of withdrawal syndrome in case of dependence on Phenazepam is about a month. After which lethargy, weakness, physical and mental exhaustion sets in.

How to ease withdrawal symptoms

Treatment of withdrawal syndrome should be carried out in a hospital, under the supervision of specialists; if acute conditions arise during treatment, intensive care and resuscitation measures are used.
The drug is withdrawn gradually under the supervision of a doctor.
After complete withdrawal of the drug, a course of detoxification therapy is carried out. Non-drug treatment:

gastric lavage;
enterosorbents (Enterosgel, Smecta);
saline laxatives.

For withdrawal symptoms caused by Phenazepam, drug detoxification is the only effective and safe method. Large volumes of liquid (saline, glucose, rheopolyglucin) are injected intravenously, and diuretics are prescribed for forced diuresis. Very carefully monitor the amount of fluid introduced and removed. The state of acid-base and water-salt balance is constantly monitored.

If necessary, additional hardware detoxification is carried out. All patients are prescribed treatment aimed at maintaining vital systems and organs (β-blockers, cardiac glycosides, hepatoprotectors, vitamin therapy).

Tests

Biological fluids (blood, urine, saliva) and tissues (hair, nails) are used as biomaterials for laboratory tests for benzodiazepines.

There are two types of tests:

Qualitative methods confirming or refuting the presence of benzodiazepines in the body (immunochromatographic studies and rapid tests).
Quantitative or laboratory toxicological methods, which are carried out in specialized laboratories using sophisticated equipment, by specially trained people. Studies make it possible to confirm the presence of benzodiazepines in the body, identify the drug and calculate the dose taken.

Urine testing is carried out using both a qualitative method (preliminary conclusion) and a quantitative method (final conclusion with legal force).

Blood, like urine, is examined using qualitative and quantitative methods. There is also an autoimmune (quarter) blood test. It is based on the fact that the body produces antibodies to benzodiazepines. Their detection in the blood indicates that the drug was taken by the person being examined 3-4 months ago.

In addition to the two main methods of examination using saliva, there is a study using the Drager Drug analyzer. The method is considered very sensitive, the result is obtained quickly.

The examination of hair and nails is carried out only in chemical and toxicological laboratories. This is the most informative method that allows you to separate a one-time use of the drug and chronic use. The method makes it possible to get an idea of the dynamics of tranquilizer consumption.

Express test (pharmacy, brands)

Express tests sold in pharmacies are qualitative research methods.

The popularity of such tests is explained by the following:

sensitivity and ease of use;
quick results;
possibility of carrying out at home;
tests are affordable for the mass buyer.

Examples of pharmacy rapid tests for benzodiazepines include the following products:

Benzodiazepine BZO (China);
ImmunoChrome-6-MULTI-express (Russia);
Express test “Be confident” (Russia);
Benzodiazepine (BZO) SERATEC (Germany).

Is it possible to cheat the test?

With proper control over the collection of biomaterial for analysis, it is impossible to cheat laboratory tests. If controls are not tight enough, some drug addicts switch urine samples.

What is Phenazepam

It is a tranquilizer with a muscle relaxant effect. It has a serious effect on the psyche, so it is sold only with a doctor's prescription. Taken in the form of tablets or white suspension.

Phenazepam helps to relax, reduce feelings of fear, and eliminate irritability. In narcology, it is used to relieve alcohol withdrawal as a multi-day therapy, but it is absolutely not suitable for treating a regular hangover. This remedy is one of the most widely known in Russia.

Phenazepam analogs

Phenazepam is part of a large group of medications - benzodiazepines. They all have a similar mechanism of action and effect on the human body. Among the representatives of this class are:

Diazepam is one of the oldest drugs, has a powerful anticonvulsant, hypnotic and sedative effect;
Clonazepam – has a good hypnotic effect, reduces the tone of striated muscles;
Bromazepam – in small doses causes an anxiolytic effect;
Flunitrazepam – has a hypnotic, sedative, anticonvulsant effect.

All benzodiazepines suppress the activity of the central nervous system, which causes changes on both the physical and mental levels. Abuse of benzodiazepines leads to impairment of memory and intelligence, speech is impaired, lethargy appears, and moral and ethical standards of behavior are violated.

Long-term use of drugs disrupts the function of all somatic organs, as well as brain structures. The group of benzodiazepines, and therefore Phenazepam, is similar in mechanism of action to the action of barbiturates and ethanol.

Historical facts

The drug was invented in the 1970s. The developers who received the state order for the new medicine were the scientific directors of the departments of pharmacology from the Odessa Institute of Physics and Chemistry. After successful research and launch of the drug on the market, the group of voters received the USSR State Prize.

The peak use of the drug came at the end of the 80s, when facts of abuse of barbiturates were published and proven. Phenazepam and its analogues have become alternative drugs with similar effects but fewer adverse reactions.

Addiction treatment

Treatment of addiction to Phenazepam is a complex and lengthy process, which must be started in an inpatient setting under the supervision of doctors.

How addiction is formed

There are three stages in the development of dependence on Phenazepam:

Stage of mental dependence. Usually they start taking Phenazepam in order to get rid of insomnia, constant fears, and feelings of anxiety. After taking the first doses, a person feels inner peace, his health improves, fears disappear, a good mood and a feeling of joy appear. However, tolerance develops very quickly; previous doses of the drug do not give the desired result. In order to again receive a charge of positive emotions, the person begins to increase the dose of the tranquilizer.
Stage of physical dependence. Taking large doses of a tranquilizer does not go away without leaving a trace. Physical and mental dysfunctions appear and begin to rapidly increase. Taking the drug no longer brings the desired result, and an attempt to cancel the tranquilizer, or reduce the dose taken, leads to the development of withdrawal syndrome.
Stage of decompensation. Physical and mental disorders in the body become irreversible. Lost interest in life. There is degradation and then disintegration of personality.

How long do drug addicts live?

Regular use of large doses of Phenazepam, especially in combination with alcohol and other psychotropics, sharply shortens life. Barbituromaniacs rarely live more than 15 years from the start of regular abuse. The most common causes of death are:

severe overdose of a tranquilizer (death occurs as a result of stopping the respiratory and vasomotor centers);
severe conditions developing against the background of withdrawal syndrome (sharp drop in blood pressure, severe forms of arrhythmias, status epilepticus);
chronic intoxication with the development of internal organ failure (acute renal, liver failure);
suicide.

Rehabilitation

Rehabilitation is the longest and most difficult stage of addiction treatment. Psychological work is one of the most difficult in medicine, requiring a lot of patience and perseverance. First of all, it is necessary to identify the reason why the patient decided to stop taking the tranquilizer, and then unobtrusively and constantly strive to strengthen this motivation.

The drug on which a person depends, and everything connected with it, occupy a very large place in the addict’s value system. It is important not only to remove the tranquilizer from the patient’s life, but also to fill the void left by this. Form a new view on the system of life values. This is facilitated by individual conversations, group classes, and various psychological techniques.

The program is considered completed if the addict sincerely, without coercion, completely voluntarily decides to stop taking the tranquilizer.

Why you can’t treat yourself at home

One of the main symptoms of drug addiction is anosognosia. A person does not realize that he is sick until it is too late. The appearance of withdrawal syndrome indicates an advanced disease. It is impossible to cope with the disease at home:

the process of gradual withdrawal of the drug should be carried out under the supervision of a doctor and adjusted in time;
it is impossible to complete a rehabilitation course without constant monitoring of the patient’s condition by a psychotherapist;
at home, a tranquilizer is constantly available;
misunderstanding by relatives of the condition in which the addict is.

Working with codependents

Often the patient’s relatives also need psychological help.

When working with codependents, a psychologist strives to:

relieve relatives from feelings of guilt and inferiority;
bring codependents out of a state of chronic depression;
explain the essence of their loved one’s illness, teach them how to properly communicate with them, so as not to provoke a breakdown.

Resocialization

Resocialization is the last stage of inpatient treatment. At this stage, the convalescent is prepared for the most painless return to social life. It is important that the person recovering is not an outside observer of the efforts of social workers and psychotherapists, but that he himself directly participates in this process.

Convalescent is helped by:

find a new job and, if necessary, undergo retraining;
strengthen weakened relationships with family;
solve the problem of free time and changing social circles.

Ambulatory treatment

Upon discharge from hospital, the risk of relapse of the disease is highest, so it is necessary to register with an outpatient psychotherapist as quickly as possible.

The doctor will help the convalescent to cope with the difficulties that he will encounter, especially in the first days outside the hospital, without resorting to a tranquilizer. Participating in various programs and communicating with other recovering people will help solve the problem of free time and change the circle of friends.