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Bromazolam
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Bromazolam
Bromazolam (XLI-268) is a triazolobenzodiazepine (TBZD) which was first synthesised in 1976, but was never marketed. It has subsequently been sold as a designer drug, first being definitively identified by the EMCDDA in Sweden in 2016. It is the bromo instead of chloro analogue of alprazolam and has similar sedative and anxiolytic effects to it and other benzodiazepines. Bromazolam is a non subtype selective agonist at the benzodiazepine site of GABAA receptors, with a binding affinity of 2.81 nM at the α1 subtype, 0.69 nM at α2 and 0.62 nM at α5. The "common" dosage range for users of bromazolam was reported to be 1–2 mg, suggesting its potency is similar to alprazolam.
Because bromazolam is relatively new, epidemiological research regarding the individual's health effects as well as the effects on the public health are quite scarce. Most of the knowledge about the effects are known from case studies and individual reports.
The typical effects of benzodiazepines used in medical science are muscle relaxation, amnesia, sedation, anxiolysis and anticonvulsive activity (used to treat epilepsy). Therefore, benzodiazepines are frequently used to treat illnesses such as anxiety, insomnia, muscle spasms or epilepsy.
Similarly to prescription benzodiazepines, bromazolam usage can lead to tolerance, addiction and dependence. Benzodiazepine-like compounds are rarely fatal when taken alone but can cause central nervous system depression when combined with other medication or drugs.
Common adverse effects of benzodiazepines are somnolence, impaired balance, ataxia, loss of coordination, impaired thinking and self-assessment capability, muscle weakness, confusion, slurred speech, blurred vision, amnesia, dizziness, drowsiness, lethargy, fatigue and palpitations. At high doses, they may induce delirium, auditory and visual hallucinations, seizures, deep sleep and coma.
To study the potential addictive nature of bromazolam a two-lever drug discrimination test was performed. Rats trained to discriminate against the benzodiazepine midazolam were used to evaluate the abuse potential of bromazolam. They found that bromazolam resulted in full dose-dependent substitution with an ED50 of 0.54 mg/kg. In comparison, the ED50 of midazolam and diazepam were 0.09 and 0.66 respectively.
Not many studies have been conducted on the biotransformation of bromazolam, mainly because this drug is relatively new. However, in a study of Wagmann et al. (2020), the biotransformation of bromazolam is studied in depth. The results of this study are described in the text below.
Blood plasma and urine of two individuals suspected of taking bromazolam were analysed for bromazolam and its metabolites. Bromazolam was detected in all four of the samples. One of the urine samples contained 8 bromazolam metabolites these were: phenyl-hydroxy bromazolam, 4-hydroxy bromazolam, α-hydroxy bromazolam, α-4-dihydroxy bromazolam, bromazolam N-glucuronide, phenyl-hydroxy bromazolam glucuronide, α-hydroxy bromazolam glucuronide, and 4-hydroxy bromazolam glucuronide. In the blood plasma sample of the same individual only the three mono-hydroxylated metabolites were found.
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Bromazolam
Bromazolam (XLI-268) is a triazolobenzodiazepine (TBZD) which was first synthesised in 1976, but was never marketed. It has subsequently been sold as a designer drug, first being definitively identified by the EMCDDA in Sweden in 2016. It is the bromo instead of chloro analogue of alprazolam and has similar sedative and anxiolytic effects to it and other benzodiazepines. Bromazolam is a non subtype selective agonist at the benzodiazepine site of GABAA receptors, with a binding affinity of 2.81 nM at the α1 subtype, 0.69 nM at α2 and 0.62 nM at α5. The "common" dosage range for users of bromazolam was reported to be 1–2 mg, suggesting its potency is similar to alprazolam.
Because bromazolam is relatively new, epidemiological research regarding the individual's health effects as well as the effects on the public health are quite scarce. Most of the knowledge about the effects are known from case studies and individual reports.
The typical effects of benzodiazepines used in medical science are muscle relaxation, amnesia, sedation, anxiolysis and anticonvulsive activity (used to treat epilepsy). Therefore, benzodiazepines are frequently used to treat illnesses such as anxiety, insomnia, muscle spasms or epilepsy.
Similarly to prescription benzodiazepines, bromazolam usage can lead to tolerance, addiction and dependence. Benzodiazepine-like compounds are rarely fatal when taken alone but can cause central nervous system depression when combined with other medication or drugs.
Common adverse effects of benzodiazepines are somnolence, impaired balance, ataxia, loss of coordination, impaired thinking and self-assessment capability, muscle weakness, confusion, slurred speech, blurred vision, amnesia, dizziness, drowsiness, lethargy, fatigue and palpitations. At high doses, they may induce delirium, auditory and visual hallucinations, seizures, deep sleep and coma.
To study the potential addictive nature of bromazolam a two-lever drug discrimination test was performed. Rats trained to discriminate against the benzodiazepine midazolam were used to evaluate the abuse potential of bromazolam. They found that bromazolam resulted in full dose-dependent substitution with an ED50 of 0.54 mg/kg. In comparison, the ED50 of midazolam and diazepam were 0.09 and 0.66 respectively.
Not many studies have been conducted on the biotransformation of bromazolam, mainly because this drug is relatively new. However, in a study of Wagmann et al. (2020), the biotransformation of bromazolam is studied in depth. The results of this study are described in the text below.
Blood plasma and urine of two individuals suspected of taking bromazolam were analysed for bromazolam and its metabolites. Bromazolam was detected in all four of the samples. One of the urine samples contained 8 bromazolam metabolites these were: phenyl-hydroxy bromazolam, 4-hydroxy bromazolam, α-hydroxy bromazolam, α-4-dihydroxy bromazolam, bromazolam N-glucuronide, phenyl-hydroxy bromazolam glucuronide, α-hydroxy bromazolam glucuronide, and 4-hydroxy bromazolam glucuronide. In the blood plasma sample of the same individual only the three mono-hydroxylated metabolites were found.
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