|Summary sheet: Etizolam|
|Common names||Etizolam, Etilaam, Etizest|
|Chemical class||Thienodiazepine / Thienotriazolodiazepine|
|Routes of Administration|
Etizolam (also known as Etilaam, Etizest, Depas, and many others) is a novel depressant substance of the thienodiazepine class. Etizolam is chemically related to benzodiazepines and acts by binding to GABA receptors in the brain.
Etizolam is not commonly prescribed. It has been sold as a research chemical online and is commonly used as a substitute for pharmaceutical benzodiazepines like alprazolam (Xanax) or diazepam (Valium). Etizolam is commonly found in pellet or pill form, laid on blotter paper, dissolved in propylene glycol or as a pure powder.
Subjective effects include anxiety suppression, disinhibition, muscle relaxation, sedation, and euphoria. Etizolam is commonly administered orally and sublingually due to the high bioavailability of these routes.
Users should note that that as with benzodiazepines, the sudden discontinuation of thienodiazepines can be dangerous or even life-threatening for long-term or heavy users. As a result, individuals who are physically dependent on this substance are advised to taper their dose by gradually lowering the amount taken each day over a prolonged period of time instead of stopping use abruptly.
History and culture
This History and culture section is a stub.
As a result, it may contain incomplete or wrong information. You can help by expanding it.
Etizolam first appeared on the online research chemical market in 2011. Since then its popularity has steadily increased. This likely owes itself to both its low cost and its abundance, and the highly dependence-forming and addictive nature that it shares with recreationally-used benzodiazepines.
Etizolam differs from most other research chemicals in that it is approved and actively prescribed as a medical treatment for anxiety in many countries around the world, commonly under brand names like Etilaam and Etizest. Its origins as a medical drug are unclear, although medical papers citing its use in the treatment of anxiety have been documented as early as the 1990s.
Etizolam is a structural relative of benzodiazepines, whereby the benzene ring has been replaced by a thiophene ring, classifying it as a thienodiazepine. Thiophene is a five membered aromatic ring with one sulfur atom. Etizolam contains a thiophene ring fused to a diazepine ring, which is a seven membered ring with the two nitrogen constituents located at R1 and R4. This forms the thienodiazepine core of etizolam. An ethyl chain is bound to this bicyclic structure at R7. Additionally, a R2' chlorine-substituted phenyl ring is bound to this structure at R5.
Etizolam also contains a methylated triazole ring fused to and incorporating R1 and R2 of its diazepine ring. Etizolam shares this fused triazole ring substitution with certain benzodiazepine drugs, called triazolobenzodiazepines, distinguished by the suffix "-zolam".
Thienodiazepines produce a variety of effects by binding to the benzodiazepine receptor site and magnifying the efficiency and effects of the neurotransmitter gamma aminobutyric acid (GABA) by acting on its receptors. As this site is the most prolific inhibitory receptor set within the brain, its modulation results in the sedating (or calming effects) of etizolam on the nervous system.
Anecdotal reports suggest that in terms of its relative potency, 1 mg of etizolam is approximately equivalent to 0.5 mg of alprazolam (Xanax), 0.5 mg of clonazepam (Klonopin), or 10 mg of diazepam (Valium). It is often compared to a less potent and sedating version of alprazolam in terms of the speed of its onset, total duration, and recreational effect.
Disclaimer: The effects listed below cite the Subjective Effect Index (SEI), an open research literature based on anecdotal user reports and the personal analyses of PsychonautWiki contributors. As a result, they should be viewed with a healthy degree of skepticism.
It is also worth noting that these effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects. Likewise, adverse effects become increasingly likely with higher doses and may include addiction, severe injury, or death ☠.
- Sedation - Etizolam is sedating in a rapid-acting fashion. At higher doses, this can lead users to suddenly feel as if they are extremely sleep deprived and have not slept for days, forcing them to sit down and generally feel as if they are constantly on the verge of passing out instead of engaging in physical activities. This sense of sleep deprivation increases proportional to dosage and eventually becomes powerful enough to force a person into complete unconsciousness.
- Muscle relaxation This effect can be described as similar to diazepam, albeit mild-moderately less prominent depending on the dose. Low doses around 0.5-1mg typically cause an effect comparable to alprazolam.
- Physical euphoria
- Motor control loss
- Respiratory depression
- Increased libido
- Seizure suppression
- Appetite enhancement - This effect is not particularly prominent, but is reported to occur in some people. It can have a synergistic effect when combined with cannabis.
- Temporary erectile dysfunction
- Paradoxical reactions to benzodiazepines such as increased seizures (in epileptics), aggression, increased anxiety, violent behavior, loss of impulse control, irritability and suicidal behavior sometimes occur (although they are rare in the general population, with an incidence rate below 1%). These paradoxical effects occur with greater frequency in recreational abusers, individuals with mental disorders, children, and patients on high-dosage regimes. Although not formally studied, thienodiazepines are assumed to share this risk.
- Anxiety suppression
- Cognitive euphoria - This effect is generally produced only at high doses, and is thought to arise largely from the release of pre-existing anxiety in the user. Many users report not feeling any pleasurable or euphoric sensations from benzodiazepines or thienodiazepines like etizolam at all.
- Compulsive redosing - Compulsive redosing likely occurs due to the rapid way in which the substance produces its anxiety-relieving, relaxing and sometimes euphoric effects before quickly dropping off. It can be made worse due to the memory suppression it produces which can lead the user forgetting they have taken any at all, which can lead to a cycle that leads to a dangerous amnesic blackout state.
- Memory suppression
- Delusions of sobriety - This is the false belief that one is perfectly sober despite obvious evidence to the contrary such as severe cognitive impairment and an inability to fully communicate with others. It most commonly occurs at high to heavy dosages.
- Analysis suppression
- Ego inflation
- Thought deceleration
- Motivation suppression
- Emotion suppression - Although this compound primarily suppresses anxiety, it also dulls other emotions in a manner which is distinct but less intensive than that of antipsychotics.
- Rebound anxiety - Rebound anxiety is a commonly observed effect with anxiety relieving substances like benzodiazepines and etizolam. It typically corresponds to the total duration spent under the substance's influence along with the total amount consumed in a given period, an effect which can easily lend itself to cycles of dependence and addiction.
- Dream potentiation or Dream suppression
- Residual sleepiness - While etizolam can be used as an effective sleep-inducing aid, its effects may persist into the morning afterwards, which may lead users to feeling "groggy" or "dull" for up to a few hours.
- Thought deceleration
- Thought disorganization
There are currently anecdotal reports which describe the effects of this compound within our experience index.
- Experience:20mg Etizolam - Smoking Etizolam
- Experience:2mg Etizolam - Here be dragons
- Experience:3mg Etizolam - A Comedown Drug
. Additional experience reports can be found here:
Toxicity and harm potential
Tolerance and addiction potential
Like most benzodiazepines, etizolam is considered to be highly addictive with a high potential for abuse.
In one study in which multiple doses of either etizolam or lorazepam were administered to rat neurons, tolerance to the anticonvulsant effects of lorazepam but not to etizolam was observed. Etizolam therefore has a reduced liability to induce tolerance, and dependence when compared with classic benzodiazepines.
Tolerance will, however, develop to the sedative-hypnotic effects within a couple of days of continuous use. After cessation, the tolerance returns to baseline in 7 - 14 days. However, in certain cases this may take significantly longer in a manner which is proportional to the duration and intensity of one's long-term usage.
Thienodiazepine discontinuation is notoriously difficult and potentially life-threatening for heavy or long-term users. There is an increased risk of seizure following discontinuation of thienodiazepines. Withdrawal symptoms or rebound symptoms may occur after ceasing usage abruptly following a few weeks or longer of steady dosing, and may necessitate a gradual dose reduction. For more information on tapering from thienodiazepines in a controlled manner, please see this guide. Substances which lower the seizure threshold such as tramadol should be avoided during withdrawal.
Thienodiazepine overdose may occur when taken in extremely heavy quantities or concurrently with other depressants. This is particularly dangerous with other GABAergic depressants such as barbiturates and alcohol since they work in a similar fashion, but bind to distinct allosteric sites on the GABAA receptor, thus their effects potentiate one another. Thienodiazepine increase the frequency in which the chlorine ion pore opens on the GABAA receptor while barbiturates increase the duration in which they are open, meaning when both are consumed, the ion pore will open more frequently and stay open longer. Thienodiazepine overdose is a medical emergency that may lead to a coma, permanent brain injury or death if not treated promptly and properly.
Symptoms of a thienodiazepine overdose may include severe thought deceleration, slurred speech, confusion, delusions, respiratory depression, coma or death. Thienodiazepine overdoses may be treated effectively in a hospital environment, with generally favorable outcomes. Thienodiazepine overdoses are sometimes treated with flumazenil, a GABAA antagonist. However, care is primarily supportive in nature.
Warning: Many psychoactive substances that are reasonably safe to use on their own can suddenly become dangerous and even life-threatening when combined with certain other substances. The following list provides some known dangerous interactions (although it is not guaranteed to include all of them).
Always conduct independent research (e.g. Google, DuckDuckGo, PubMed) to ensure that a combination of two or more substances is safe to consume. Some of the listed interactions have been sourced from TripSit.
- Depressants (1,4-Butanediol, 2-methyl-2-butanol, alcohol, barbiturates, GHB/GBL, methaqualone, opioids) - This combination can result in dangerous or even fatal levels of respiratory depression. These substances potentiate the muscle relaxation, sedation and amnesia caused by one another and can lead to unexpected loss of consciousness at high doses. There is also an increased risk of vomiting during unconsciousness and death from the resulting suffocation. If this occurs, users should attempt to fall asleep in the recovery position or have a friend move them into it.
- Dissociatives - This combination can result in an increased risk of vomiting during unconsciousness and death from the resulting suffocation. If this occurs, users should attempt to fall asleep in the recovery position or have a friend move them into it.
- Stimulants - It is dangerous to combine thienzodiazepines with stimulants due to the risk of excessive intoxication. Stimulants mask the sedative effect of thienzodiazepines, which is the main factor most people consider when determining their level of intoxication. Once the stimulant wears off, the effects of thienzodiazepines will be significantly increased, leading to intensified disinhibition. If combined, one should strictly limit themselves to only dose a certain amount of thienzodiazepines per hour. This combination can also potentially result in severe dehydration if hydration is not monitored.
- Australia: Schedule 4 issued by the Office of Drug Control, in accordance with Regulation 5 of the Customs (Prohibited Imports) Regulations 1956. Does not state it is Schedule 4 in Poison Standard October 2020, but it may fall under the analog act for deschloroetizolam. License and permit are required for import/export.
- Austria: Etizolam is illegal to possess, produce, supply, or import since 2012 under the NPSG (Neue Psychoaktive Substanzen Gesetz). However, offenders with no intent to distribute will likely not have to face a charge.
- Brazil: Since March 23, 2021, due to ANVISA's Resolution RDC nº 473, possession, production and sale is illegal as it is listed on Portaria SVS/MS nº 344.
- Canada: Etizolam appears to be captured under section 18 of the CDSA's Schedule VI as "Benzodiazepines, salts thereof and their derivatives"
- Germany: Etizolam is controlled under Anlage III BtMG (Narcotics Act, Schedule III) as of July 17, 2013. It can only be prescribed on a narcotic prescription form.
- Japan: Etizolam is controlled by Japan by the Narcotics and Psychotropics Control Law, which makes it illegal to possess, sell, or manufacture it without a prescription.
- Poland: Etizolam is a NPS class drug in Poland, making it illegal to possess or distribute.
- Russia: In Russia, since 2017, etizolam is a Schedule III controlled substance.
- Switzerland: Etizolam is a controlled substance specifically named under Verzeichnis B. Medicinal use is permitted.
- Turkey: Etizolam is a classed as drug and is illegal to possess, produce, supply, or import. 
- United Kingdom: As of May 31st, 2017, etizolam is a Class C substance in the United Kingdom, making it illegal to possess, produce, or supply.
- United States: Etizolam is not federally prohibited in the United States. However, some state legislatures have passed laws prohibiting it in their jurisdictions. As of July 2019, etizolam is a controlled substance in the following states: Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Texas, South Carolina and Virginia, Indiana, and Ohio.
- Arizona: In 2018, The State Of Arizona Legislature has listed Etizolam as a controlled substance under House Bill 2033
- Arkansas: In August 2014, the state of Arkansas listed etizolam as a Schedule I substance under its substance scheduling guidelines.
- North Carolina: On March 22, 2017, the General Assembly of North Carolina enacted an addendum to the North Carolina Controlled Substances Act including etizolam as a Schedule I substance.
- Texas: On Jun 9, 2017, the state of Texas listed etizolam as a Penalty Group 3 substance with HB 2671. Contrary to some online reports and conflicting information with the overall Texas controlled substance list website, etizolam became a penalty group 3 substance with the passage of this bill.
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