In general, tranquilizers, unlike other psychotropic drugs (antipsychotics, antidepressants) are characterized by the absence of serious side effects and good tolerability. Specialists distinguish the following main side effects:
- hypersedation – dose-dependent daytime sleepiness, decreased wakefulness, impaired coordination of attention, forgetfulness, etc.
- miorelaxation – relaxation of skeletal muscles, manifested by general weakness, weakness in individual muscle groups
- “behavioral toxicity” – an easy disruption of cognitive functions and psychomotor skills, manifested even in small doses and detected in neuropsychological testing
- “paradoxical” reactions – increased aggression and agitation (excited state), sleep disorders, usually passing spontaneously or after a dose reduction
- mental and physical dependence that occurs with prolonged use (6-12 months continuously), the manifestations of which resemble a neurotic anxiety.
These side effects are most common in benzodiazepines, especially Xanax and others from the pharmacies, which can also cause arterial hypotension (especially with parenteral administration), dry mouth, dyspepsia (nausea, vomiting, diarrhea or constipation), increased appetite during the food intake, dysuria (urinary disorders), violation of sexual desire and potency. Benzodiazepines can increase intraocular pressure, so it is contraindicated in closed-angle glaucoma. With long-term use, tolerance is possible. Allergic reactions are rare.
In terms of frequency, lethargy and drowsiness are leading, occurring in about 10% of cases, including the next day within the framework of “residual events” after the evening reception of the drug on the eve. In 5-10 times, there are fewer dizziness and ataxia (violation of coordination of movements) associated with muscle relaxation. However, in the elderly people, these side effects are increasing. In connection with these properties, a contraindication to the use of tranquilizers is myasthenia gravis.
Deepening sleep and myorelaxation caused by tranquilizers cause such a contraindication to their use, as a syndrome of nocturnal sleep apnea – long respiratory pauses in sleep, usually occurring in snoring patients. In this case, hypoxia takes place, the development of myocardial ischemia is possible. Tranquilizers make awakening difficult when breathing stops and relaxing the muscles of the soft palate, sagging and obstructing the flow of air into the larynx and further, into the trachea, leads to aggravation of hypoxia. In this regard, it is appropriate to recall the old recommendation to refrain from using any sleeping pills in snoring patients.
There can appear an increased aggressiveness as a manifestation of “paradoxical” reactions and, therefore, it is recommended to take this drug for not more than 10 days only as a hypnotic. Strengthening aggressiveness or agitation can be difficult to relate clearly to the use of tranquilizers. It can be a manifestation of the course of the disease and not a side effect of the drugs under consideration.
In connection with the adverse effect on the intrauterine fetus, anxiolytics are contraindicated in pregnancy. Tranquilizers, especially benzodiazepines, easily penetrate the placenta. Tranquilizers penetrate into breast milk.