Mistaken as a sleeping pill, Lexomil® is a powerful benzodiazepine whose active substance is bromazepam. How to use it properly? What are the risks of overdose or addiction? Dr Gérard Macqueron, psychiatrist, answers essential questions about this flagship treatment.
What is Lexomil® and how does it help with anxiety? About sleep? This medication, based on bromazepam, is a widely used anxiolytic, but should not be consumed lightly. From respecting the dosage to managing side effects, Dr Gérard Macqueron, psychiatrist, explains everything you need to know about this treatment.
What are the effects of Lexomil?
Lexomil® belongs to the class of benzodiazepines. It mainly acts on the central nervous system by enhancing the action of GABA, an inhibitory neurotransmitter, which provides anxiolytic, sedative and relaxing effects.
Generic: what are the other names of Lexomil?
Lexomil® is available in several generic forms: Bromazepam EG, Bromazepam Mylan, Bromazepam Biogaran, Bromazepam Sandoz, Bromazepam Cristers, Bromazepam Zentiva…
When does a doctor prescribe Lexomil?
Lexomil® is officially authorized for manifestations of anxiety even if it is very often taken against insomnia. “The use of Lexomil should be restricted to two situations: either to a proven anxiety disorder in association with psychotherapy and/or a basic treatment of the anxiety disorder. Which paradoxically turns out to be an antidepressant, particularly serotonergic such as Prozac®; or occasionally when an acute anxiety attack occurs”, recalls Dr Gérard Macqueron, psychiatrist in Paris.
Why does Lexomil make you sleep? Is 1/4 enough?
Lexomil® has an anxiolytic effect which reduces nervous tension, and a sedative effect which causes overall relaxation of the body which leads to a feeling of fatigue, or even falling asleep. But Lexomil® is not a sleeping pill and its misuse for sleep can degrade the quality of sleep rather than improve it. To sleep, “we will prefer to prescribe a benzodiazepine with a short half-life (which remains less long in the body) such as Imovane® or Havlane® for a very short period. That is to say less than 4 weeks”, explains the psychiatrist. To avoid the sedative effects and dependence on Lexomil® but sleep better, some people limit themselves to 1/4 of a tablet. Warning: adjusting your dose prevents your doctor from accurately assessing the effectiveness of the treatment. It is better to talk to him about it before changing the dosage of such a medication on your own.
What is the half-life of Lexomil?
The half-life of Lexomil® is on average 20 hours, which means that it takes the body 20 hours to completely eliminate the drug after each dose. This duration explains why effects such as drowsiness or a feeling of mental fog can persist the next day, especially at the start of treatment. This persistence in the body also justifies the need to strictly respect the prescribed dosage, without changing the doses yourself. During daily treatment, the medication does not have time to be completely eliminated before the next dose. The blood concentration stabilizes over the long term but this justifies strict medical monitoring to avoid overdose.
Can you take Lexomil during pregnancy?
The use of Lexomil® should be avoided during the first trimester. “In pregnant women, malformations, mainly cleft palates, have been reported. Furthermore, at the end of pregnancy, there is a risk for the newborn to be impregnated with benzodiazepines (respiratory disorders, apnea, hypothermia and difficulty sucking) or to present a withdrawal syndrome (agitation, convulsions). This is why it is recommended not to prescribe benzodiazepine at the end of pregnancy. Furthermore, due to their passage into breast milk and the sedative effects, breastfeeding should be stopped if their prescription is essential.replies the psychiatrist.
What are the effects of stopping taking it?
The long half-life of Lexomil® (20 hours) explains why, when stopping, withdrawal symptoms (rebound anxiety, insomnia) do not always occur immediately, but sometimes a few days after the last dose, until the molecule completely disappears from the body. “These reactions can be prevented by favoring the lowest doses, prescription for a limited duration and a gradual reduction of doses before definitively stopping treatment” explains Dr Gérard Macqueron. Finally, let’s not forget that alternatives to Lexomil® and other benzodiazepines exist. Meditation, creativity (music, dance, painting, etc.) and sporting activity are all effective natural ways to manage daily stress. In cases of proven anxiety disorders, CBT is a particularly effective therapy.continues the specialist.
Can you get Lexomil without a prescription?
No. Lexomil® cannot under any circumstances be dispensed without a prescription. Due to its composition (benzodiazepine), it is classified on list I, which makes medical consultation mandatory. A Lexomil® prescription is not renewable by default.
Contraindications of Lexomil
This medicine should never be used in the following situations:
- Known hypersensitivity to benzodiazepines, the active ingredient or any of its constituents
- Severe respiratory failure
- Severe, acute or chronic liver failure
- Myasthenia
- Sleep apnea
- In subjects over 65 years of age, it is recommended to reduce the dosage of benzodiazepines, because there is a risk of accumulation and overdose.
“In addicted patients, the very high risk of dependence will make us avoid the use of benzodiazepines as much as possible,” specifies Dr Macqueron.
