I was sectioned after being given a tranquiliser for anxiety that triggered a ... trends now

Emma Saunders, an actress and photographer, went to her father's private GP in Chelsea with tinnitus in November 2020. 'I'd woken up with a loud ringing in my ears — it was distressing because I'd not had anything like it before and didn't know what was going on,' she says.

'I went privately because I expected the doctor to have contacts and to refer me to a specialist for tests.'

Instead, the GP prescribed a tranquilliser, lorazepam, telling Emma, then 34, it would calm her down and help her sleep.

'The doctor obviously thought I was having a meltdown — he said he was going to give me something to take until the pandemic was over [the UK was then in a national lockdown] and life got back to normal,' she says.

Emma believes the decision to take the medication changed the course of her life for the worse and she is still suffering now.

'Over the next three years, I was sectioned and admitted to three psychiatric hospitals. I became psychotic and was in such unbearable physical and mental agony that I tried to kill myself several times.'

She adds: 'Three-and-a-half years later I'm still unwell. I've got long-term nerve damage, have severe migraines and pain in my eyes and am often confined to my bed for weeks because I'm so unwell.'

Emma's story began with a tranquilliser, but her worsening condition and long-term health problems are linked to the side-effects of the drug itself — but as is too often the case, these symptoms were seen as her condition worsening — rather than down to the drug itself, leading to more medication, triggering an agonising condition called akathisia.

This is a dangerous side-effect of some medications, mainly antipsychotics, but it can also occur with antidepressants and even some antibiotics.

Akathisia causes intense restlessness, an inability to keep still and a feeling of terror. It can drive patients to kill themselves.

Lorazepam is a benzodiazepine, a type of drug used to treat conditions such as anxiety, depression and insomnia.

'The GP said it was completely safe and I could take it until the end of lockdown [which lasted, with periods of relaxation of the rules in between, for another six months],' says Emma.

'I thought nothing of it because he's a doctor and I trusted him.'

In fact, under official guidelines, these drugs should be prescribed for no more than two to four weeks, and should not be used as first-line treatments for conditions such as anxiety — the guidelines also warn that being dependent on them is common between two to four weeks of taking them.

As David Healy, a former professor of psychiatry at the University of Wales who is an expert in the side-effects of psychiatric medication, explains: 'These drugs can be useful for treating short-term anxiety, but in the longer term they can be lethal.

'People can get hooked on them in just a week and withdrawal problems can be so severe that some people are unable to get off them, or do so with devastating consequences.'

I remember first coming across the problems these pills cause in the 1980s when I was a researcher working on the TV consumer programme That's Life!

Benzodiazepine addiction was one of the campaigns championed by my then boss, Esther Rantzen. In the following decades, 117 UK GPs and 50 health authorities were sued by patients to recover damages for the harmful effects of dependence and withdrawal.

Yet despite such concerns and despite the official guidelines, nearly 1.5 million people in England alone take benzodiazepines.

Thousands more are on them for longer than as set out in official guidelines — 120,000 people were given continuous prescriptions for benzodiazepines between April 2015 and March 2018, according to the latest figures from the National Institute for Health and Care Excellence.

It's not 'simply' that people are being put on — and then left on — these drugs inappropriately, there is a worrying lack of awareness among healthcare professionals about the side-effects. Emma began having problems with lorazepam after just a month of starting to take it.

'It helped me to sleep at first, but then it began to have the opposite effect,' she says.

'I was waking up in the early hours in a state of terror. It got worse until it wasn't just in the middle of the night, it was throughout the day, too.'

(A lesser concern was that it hadn't helped her tinnitus either, more on that later.)

Professor Healy explains: 'Lorazepam is a short-acting drug which means it may put you to sleep but, after a few hours, it will wash out of your system and you will wake up again.'

He says what Emma experienced sounds like 'interdose' withdrawal — 'this happens when withdrawal symptoms emerge in between scheduled doses: the problem with benzodiazepines is that they can cause the things they treat, so when the drug wears off patients can get rebound anxiety or rebound insomnia'.

Emma asked her GP if she should continue taking the drug 'and he said it was safe to carry on with it', she recalls.

With Covid travel restrictions relaxed, Emma had gone to stay with her father in Spain.

'I was in the glorious sunshine but I felt anxious all the time,' she says. 'I couldn't eat, concentrate or do anything.'

Eight weeks after starting on lorazepam Emma saw a doctor in Spain who diagnosed what she now knows was interdose withdrawal as anxiety, and prescribed citalopram as well. This is a type of SSRI (selective serotonin reuptake inhibitor), a class of antidepressants that is widely prescribed.

Emma's condition became worse, she recalls: 'Within hours of taking it, I started having a feeling of constant terror, I was rocking back and forth in my bed and I was unable to sit still.'

Her inability to keep still is characteristic of akathisia.

Professor Healy explains: 'This is an agonising disorder which is typically caused by antipsychotics, but can also be caused by antidepressants, benzodiazepines and some other medications, such as antiemetics [used to prevent nausea]; pregabalin [for epilepsy, anxiety and nerve pain]; antimalarials and even some antibiotics.

'It tends to happen when people first go on the drug, come off or change dose. I've seen people who are pacing and screaming and banging their heads against walls because they are so distressed by it,' says Professor Healy.

While the exact cause and the proportion of people taking medication who are affected by akathisia are not known, in a study Professor Healy ran in 2000, where 20 healthy people were given the SSRI sertraline, one in ten developed akathisia, reported the journal Primary Care Psychiatry.

Nicole Lamberson is the medical director of Benzodiazepine Information Coalition — a U.S. based support group of patients and medical professionals. She says they are contacted by sufferers from all over the world, including many in the UK.

'We hear regularly that

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