Phenazepam
A new, dangerous illicit drug may be gaining in popularity in several countries, according to a report issued in the British Medical Journal.
The drug, phenazepam, is a benzodiazepine used for the treatment of epilepsy. It is no longer prescribed in the United States and several other countries. But it's available in some Eastern European nations and may be distributed via the Internet.
Doctors in Scotland reported nine cases of overdose deaths in which phenazepam was found in blood samples. Two deaths have been linked to the drug in the United States within the last year.
Doctors should be aware that people may be abusing the drug in place of other benzodiazepines or designer drugs, said the author of the report.
An average phenazepam dosage is 0.5 mg 2-3 times daily. The maximum daily dosage must not exceed 10 mg. 1mg of phenazepam is thought to be equivalent to 5 mg diazepam.
Side effects include:
- hiccups
- dizziness
- loss of coordination
- drowsiness
- anterograde amnesia which can be quite pronounced at high doses
As with other benzodiazepines, in case of abrupt discontinuation following prolonged use, severe withdrawal symptoms may occur including restlessness, anxiety, insomnia, seizures, convulsions and death.
Benzodiazepines require special precaution if used in the elderly, during pregnancy, in children, alcohol or drug-dependent individuals and individuals with comorbid psychiatric disorders.
Phenazepam should not be taken with alcohol or any other CNS depressants. Phenazepam should not be used therapeutically for periods of longer than one month including tapering on and off the drug as recommended for any benzodiazepine in the british national formulary. Some patients may require longer term treatment.
Phenazepam may be measured in blood or plasma by chromatographic methods.
Blood phenazepam concentrations are typically less than 30 μg/L during therapeutic usage, but have frequently been in the 100-600 μg/L range in automotive vehicle operators arrested for impaired driving ability.
Phenazepam does not appear in the list of Controlled Substances in the Laws of either the USA or the UK, where in each country, benzodiazepines are generally Class C, Schedule IV substances.
The UK home office banned importation of phenazepam on Friday 22nd July 2011,the drug will be added to the misuse of drugs act 1971 at a later date as a Class C drug.
In the United States the Federal Analog Act applies only to substances classified as Schedule I and Schedule II, where as all controlled benzodiazepines under the Controlled Substances Act are classified as Schedule IV. Phenazepam is currently not controlled.
