Commonly referred to as flunitrazepam, Rohypnol is a benzodiazepine that is used to treat severe insomnia. Like other hypnotics, it has the same general properties as Valium. Rohypnol (Flunitrazepam) is only used for short-term use and should only be prescribed to patients with chronic insomnia.
Flunitrazepam was first used in medical use in 1974. It is also known for being used as a date rape drug.
In some countries, flunitrazepam is also used as a preanesthetic agent. It was originally studied for treating severe cases of insomnia.
In addition, it can be used as a combination with ketamine for treating patients who are taking the drug. Rohypnol lowers the effects of ketamine, which can result in less confusion and less negative effects on a patient’s pulse rate and blood pressure.
History
The drug was discovered by Leo Sternbach at the company of Swiss pharmaceutical giant, Roche. Its patent was first filed in 1960.
Due to the use of the drug for recreational purposes, such as date rape, in 1998, the company modified the formulation of the drug. It was not approved in the US. In 2016, the drug was withdrawn from the market in the UK, France, Germany, Spain, and Norway.
Dependence on Rohypnol
Like other benzodiazepines, Rohypnol can cause drug dependence. Withdrawal syndrome is a type of anxiety disorder that can manifest in seizures, hallucinations, and insomnia. Patients who stop taking rohypnol after a short-term course of treatment may experience a worse form of insomnia known as reoccurrence.
Effects of Rohypnol
Rohypnol’s side effects can also include dependency, depression, and somnolence. In addition to these, it can cause overdose, respiratory depression, and impairment of balance and speech. These conditions are known to be fatal. In late pregnancy, the drug can cause hypotonia.
Some people may experience a paradoxical reaction when taking flunitrazepam. These include agitation, anxiety, confusion, disinhibition, violent behavior, and loss of impulse control. These effects may also lead to criminal behavior.
When taken in high doses, Rohypnol can also cause hypotonia. This condition, which is also known as floppy baby syndrome, can occur during the late stages of pregnancy. This is because the drug rapidly crosses into the placenta.
The effects of rohypnol can also impair a person’s cognitive functions. These include lack of concentration and anterograde amnesia, which occurs when a person cannot remember anything that happened while they were under the influence of alcohol. It can be referred to as a hangover-like effect. In addition, the combination of alcohol and the drug can cause falls and hip fractures.
Detection of Rohypnol (Flunitrazepam)
In 2016, blood tests were able to identify flunitrazepam in concentrations of around 4 nanograms per millilitre. In urine samples, metabolites can also be detected up to 28 days after the use of the drug. In saliva and hair, the substances can be analyzed for up to 60 hours depending on the method used.
In the presence of rohypnol, blood or plasma can be analyzed to confirm the diagnosis of poisoning or provide evidence for an arrest for impaired driving. The concentrations of this drug can also be used to help in an investigation of a fatal overdose.
In most cases, urine is the preferred specimen for substance use monitoring. The presence of a pharmacologically active metabolite, known as 7-aminoflunitrazepam, can be used to confirm the consumption of flunitrazepam. In the case of postmortem specimens, the drug’s parent substance may have degraded to 7-aminoflunitrazepam. Other metabolites such as 3-hydroxydesmethylflunitrazepam and desmethylflunitrazepam can also be detected.
Precautions
In addition to pregnancy, people taking benzodiazepines should also be extra careful when it comes to their use in the elderly, those with mental disorders, and those who are dependent on alcohol or drugs.
One of the most common adverse effects of rohypnol is the impairment of one’s driving skills. This side-effect is not unique to the drug but can also occur with other hypnotic drugs. People who are taking this drug should take extreme caution and avoid getting behind the wheel after using it.
Rohypnol is also known to be involved in drug intoxication. In severe cases, overdose can result in an impairment of speech or balance. The risk of overdose increases if the drug is combined with other central nervous system (CNS) depressants such as alcohol and opioids. These drugs can cause a person to overdose and potentially die. Rohypnol overdose can be treated by inhibiting the effects of flumazenil.
Chemistry
N-methyl derivative of nitrazepam, rohypnol, is a nitro-benzodiazepine. Other similar compounds include clonazepam, nitrazepam, and nimetazepam.
Pharmacology
The main effects of rohypnol are its ability to enhance the inhibitory activity of certain neurotransmitters, such as the gamma-aminobutyric acid (GABA). About 80% of the drug is absorbed by the body in its oral form.
The half-life of rohypnol is approximately 18 to 26 hours. This means that its effects can last for up to a day following nighttime administration. This is because its active metabolites are able to prolong the duration of action of the drug.
The drug is metabolized by the liver through an oxidative pathway. The main enzyme responsible for this process is CYP3A4. In human liver microsomes, this enzyme is responsible for the first phase of metabolism.
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