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Trade namesEtizest, Etilaam, Etizex, Depas, Sedekopan, Pasaden, others
Other namesEtiz, etizzy[1]
  • 4-(2-Chlorophenyl)-2-ethyl-9-methyl-6H-thieno[3,2-f][1,2,4]triazolo[4,3-a][1,4]diazepine
Clinical data
Drug classThienodiazepine
Main usesGeneral anxiety disorder, panic disorder, insomnia[1][2]
Side effectsSleepiness, muscle weakness, poor coordination, fainting, headache, confusion, slurred speech, sexual dysfunction, abuse[2]
Dependence riskModerate[1]
Routes of
By mouth, under the tongue, rectal
Duration of action5-7 hours
Legal status
  • DE: Anlage III (Special prescription form required)
  • UK: Class C
  • US: Unscheduled - Schedule I in Alabama, Arkansas, Florida, Louisiana, Mississippi, Ohio, Oregon, and Virginia; Schedule IV in Georgia, Texas, and South Carolina;[3] scheduled in Arizona[4] and Indiana;[5] not FDA approved.
  • UN: Psychotropic Schedule IV
Elimination half-life3.4 hours[6][7] (main metabolite is 8.2 hours)[8]
Chemical and physical data
Molar mass342.85 g·mol−1

Etizolam, sold the brand name Depas among others, is medication used for general anxiety disorder, panic disorder, and insomnia.[1][2] It may be used short term but does not appear to be better than benzodiazepines.[9] It is taken by mouth.[1]

Side effects may include sleepiness, muscle weakness, poor coordination, fainting, headache, confusion, slurred speech, and sexual dysfunction.[2] There is also a risk of abuse and dependence.[2] It is a thienodiazepine, which are similar to benzodiazepines.[2] It actions via the benzodiazepine site of the GABAA receptors.[1] It possesses anxiolytic, anticonvulsant, sedative, hypnotic, and skeletal muscle relaxant effects.[2]

Etizolam was patented in 1971 and approved for medical use in 1984.[10][2] As of 2020 it was approved for medical use in Japan, Italy, and India but not in the United States.[1][2] There has been concerns regarding increasing misuse in Europe and the United States.[1] It is also known by a number of street names including Etiz and Etizzy.[1]

Medical uses

  • Short-term treatment of insomnia.
  • Anxiety disorders such as OCD and general anxiety disorder, however mostly considered a short-term medication to then be used purely on an at need basis[11]


The typical dose is 0.5 mg to 1 mg twice per day.[1][9]

Side effects

Long term use may result in blepharospasms,[12] especially in women.[13] Doses of 4 mg or more may cause anterograde amnesia.[citation needed]

In rare cases, erythema annulare centrifugum skin lesions have resulted.[14]

Tolerance and withdrawal

Abrupt or rapid discontinuation from etizolam, as with benzodiazepines, may result in the appearance of the benzodiazepine withdrawal syndrome, including rebound insomnia.[15] Neuroleptic malignant syndrome, a rare event in benzodiazepine withdrawal, has been documented in a case of abrupt withdrawal from etizolam.[16] This is particularly relevant given etizolam's short half life relative to benzodiazepines such as diazepam resulting in a more rapid drug level decrease in blood plasma levels.[17]


Itraconazole and fluvoxamine slow down the rate of elimination of etizolam, leading to accumulation of etizolam, therefore increasing its pharmacological effects.[18][19] Carbamazepine speeds up the metabolism of etizolam, resulting in reduced pharmacological effects.[20]


Cases of intentional suicide by overdose using etizolam in combination with GABA agonists have been reported.[21][22] Although etizolam has a lower LD50 than certain benzodiazepines, the LD50 is still far beyond the prescribed or recommended dose. Flumazenil, a GABA antagonist agent used to reverse benzodiazepine overdoses, also inhibits the effect of etizolam.[1]

Etizolam overdose deaths are rising - for instance, the National Records of Scotland report on drug-related deaths, 'street' Etizolam was a factor in ("implicated in, or potentially contributed to") 752, or 59%, of drug-related deaths in Scotland in 2019. It is important to highlight that more than one drug contributed to the vast majority of the deaths (by way of comparison, opiates and opioids were a factor in 1092, or 86%, of drug-related deaths).[23]


Etizolam, a thienodiazepine derivative, is absorbed fairly rapidly, with peak plasma levels achieved between 30 minutes and 2 hours. It has a mean elimination half life of about 3.4 hours.[8][6][7] Etizolam possesses potent hypnotic properties,[24] and is comparable with other short-acting benzodiazepines.[8] Etizolam acts as a full agonist at the benzodiazepine/GABAa receptor to produce its range of therapeutic and adverse effects.[25]

The etizolam molecule differs from a benzodiazepine in that the benzene ring has been replaced by a thiophene ring and triazole ring has been fused, making the drug a thienotriazolodiazepine.[26][27]

According to the Italian prescribing information sheet,[citation needed] etizolam belongs to a new class of diazepines, thienotriazolodiazepines. This new class is easily oxidized, rapidly metabolized, and has a lower risk of accumulation, even after prolonged treatment. Etizolam has an anxiolytic action about 6-8 times greater than that of diazepam. Etizolam produces, especially at higher dosages, a reduction in time taken to fall asleep, an increase in total sleep time, and a reduction in the number of awakenings. During tests, there were no substantial changes in deep sleep; however, it may reduce REM sleep. In EEG tests of healthy volunteers, etizolam showed some similar characteristics to tricyclic antidepressants.[28][29]

Etizolam's main metabolites in humans are alpha-hydroxyetizolam and 8-hydroxyetizolam. alpha-Hydroxyetizolam is pharmacologically active and has a half-life of approximately 8.2 hours.[21]

Society and culture

Brand names

Etilaam, Sedekopan, Etizest, Etizex, Pasaden, Depas, others.

Legal status

International drug control conventions

On December 13, 2019, the World Health Organization recommended etizolam be placed in Schedule 4 of the 1971 Convention on Psychotropic Substances.[30] This recommendation was followed by the placement of etizolam into Schedule IV in March 2020.[31]


Etizolam is not used medically in Australia.[32]


Etizolam is controlled in Denmark under the Danish Misuse of Drugs Act.[33]


Etizolam was controlled in Germany in July 2013.[34][35]


Etizolam is licensed for the treatment of anxiety, insomnia and neurosis as a prescription-only medication.[36]


United Kingdom

In the UK, etizolam has been classified as a Class C drug by the May 2017 amendment to The Misuse of Drugs Act 1971 along with several other designer benzodiazepine drugs.[38]

United States

Etizolam is not authorized by the FDA for medical use in the U.S. However, it currently remains unscheduled at the federal level and is legal for research purposes as of March 2020.[7] As of March 2016, etizolam is a controlled substance in the following states: Alabama,[39] Arkansas,[40] Florida,[41] Georgia (as Schedule IV, whereas all other states listed here prohibit it as a Schedule I substance), Louisiana, Mississippi,[42] Texas,[43] South Carolina,[3] and Virginia.[44] It is controlled in Indiana as of July 1, 2017.[5] It is controlled in Ohio as of February 2018.


Etizolam is a drug of potential misuse. Cases of etizolam dependence have been documented in the medical literature.[45] However, conflicting reports from the World Health Organization, made public in 1991, dispute the misuse claims.[46] Since 1991, cases of etizolam misuse and addiction have substantially increased,[47] due to varying levels of accessibility and cultural popularity.[48] Pills being sold as Xanax or other benzodiazepines that are illicitly manufactured may often contain etizolam rather than their listed ingredient [49][50]

See also


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External links