Dalmane is a very potent, fast-acting benzodiazepine that has a significant potential for abuse and the development of an addiction.
The chemical name for Dalmane is flurazepam. It is a drug that has hypnotic, sedative, anti-anxiety, and anticonvulsant properties.
The drug is primarily used to treat mild to moderate insomnia because it is very potent (effective in small amounts), and it has a very rapid onset of action (effects felt quickly). Unfortunately, these aspects of the drug which make it attractive for the treatment of insomnia also make it attractive as a drug of abuse.
Mechanism of Action
The drug was marketed in the United States in the 1970s, and it was one of the first of the benzodiazepine medicines to be advertised as a sleep aid.
Like all benzodiazepines, it works on a specific GABA receptor in the brain (gamma-aminobutyric acid receptor) to increase the amounts of GABA in the central nervous system. GABA is the major inhibitory neurotransmitter in the brain. It suppresses the functioning of other neurons when it is released.
The most common side effects of flurazepam are drowsiness, lethargy, dizziness, issues with memory (especially in younger and older users), and problems with movement (ataxia). The drug is also notorious for producing issues the day after using it.
One of the major side effects of the drug is due to its long half-life in the body. It has a specific metabolite that has a half-life of 47 to 100 hours. This means that individuals who use the drug for sleep will often wake up extremely drowsy or lethargic the next day, or they will wake up with a hangover, similar to the hangover that occurs with heavy alcohol use.
Abuse of Dalmane
Flurazepam products are controlled substances and can only be legally obtained with a prescription from a physician. They are not designed to be taken with other substances that suppress or depress the functioning of the central nervous system; however, abusers commonly engage in this practice.
Dalmane is usually not the sole or main drug of abuse. It is often abused with other potentially dangerous drugs, including alcohol, other benzodiazepines, and opiates.
Combining central nervous system depressants increases their effects. Smaller amounts of either drug can lead to serious negative effects when these drugs are taken together, including an increased risk for a potentially fatal overdose.
There are generally two types of individuals who abuse Dalmane:
- Polysubstance abusers
- Those who the drug medicinally for a long time and develop significant tolerance, which results in them using more of it than prescribed
Physical Dependence Potential
Flurazepam products are not designed to be used for more than a couple weeks. The most rapid development of tolerance occurs due to the sedating effects of benzodiazepines (often within seven days), particularly benzodiazepines that are very potent and quick-acting. This means that people who use the drug for more than a couple of weeks will begin to notice that they are not experiencing the effects of the drug.
People who are abusing the drug will begin to take higher doses to get the effects they seek. This can lead to a serious situation where an individual rapidly develops a physical dependence on the drug.
Drugs like dalmane that are very potent and deliver quick effects are the most likely benzodiazepines to be abused.
The withdrawal syndrome associated with Dalmane is similar to the withdrawal syndrome that occurs with all benzodiazepines.
Typically, symptoms will begin to appear within 24 to 96 hours after discontinuation. They will peak within 12 days after last use, and they are typically fully resolved after two weeks.
The timeline can be quite variable. Some individuals may continue to experience issues with withdrawal for six weeks or longer.
Withdrawal symptoms include flu-like symptoms, increased heart rate, high blood pressure, sweating, tremors, anxiety, depression, irritability, restlessness, appetite loss, insomnia, seizures, and potential psychosis or delirium tremens.
Who Should Not Use Flurazepam?
Flurazepam is generally not indicated for some individuals.
- Elderly individuals and children are especially sensitive to high-potency benzodiazepines like Dalmane. They should only be given to these individuals while under the strict supervision of a physician.
- Senior citizens are especially prone to developing cognitive problems when they take drugs like Dalmane. The risk of developing dementia increases significantly in this group.
- Individuals with a history of substance abuse should not be prescribed Dalmane unless they are strictly monitored for potential abuse.
- Pregnant women should not use Dalmane.
Treatment for Abuse
Anyone who is using or abusing Dalmane should only discontinue it under the supervision of a physician. Withdrawal symptoms associated with benzodiazepines can include potentially fatal seizures, disorientation, confusion, hallucinations, and psychosis.
There is also a significant potential for relapse during withdrawal. Because tolerance to Dalmane develops and decreases rapidly, the likelihood of overdose during relapse is increased.