Benzodiazepine-Associated Risks

Benzodiazepines are medications that lower the activity of the nerves in the brain and cause you to be drowsy. They can be used to treat problems such as general anxiety disorder, panic attacks, difficulty sleeping, alcohol withdrawal, and seizures.

How do they work?

Benzodiazepines work by boosting the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a chemical that reduces electrical activity in the brain.

What are some examples of benzodiazepines?

  • Ativan® (lorazepam)
  • Xanax® (alprazolam)
  • Klonopin® (clonazepam)
  • Librium®(chlordiazepoxide)
  • Restoril® (temazepam)
  • Valium® (diazepam)
  • Halcion® (triazolam)

When should they be used for treatment?

  • Benzodiazepines are recommended for short-term relief of symptoms such as anxiety or difficulty sleeping.
  • Long-term use is only considered when the best treatments for problems such as anxiety, sleep, or seizures are not working.
  • Long-term use must be done under close direction of the prescriber.
  • These medications should only be used when prescribed for medical treatment.
  • Use in people aged 55 and older should be avoided.

Are these medications safe to use?

Long-term use

  • When used in older people for long-term use this can increase the risk of memory problems, drowsiness, falls, and motor vehicle accidents.
  • ​Long-term use can lead to tolerance where the body needs higher doses to get the same benefit as when the medication was first started.

Side effects

  • Severe side effects of this medication are trouble breathing, severe drowsiness, slowed heart rate, low blood pressure, and fainting.
  • Some benzodiazepines can last for a long time and build up in the body, which can increase the risk of side effects.
  • Benzodiazepines should be used with caution when taking other medications that cause drowsiness, such as opioid pain medications, as this can lead to overdose, hospitalization, and possibly death.

Drug abuse

  • Benzodiazepines can be addictive and lead to severe mental and physical addiction.
  • Most people that become addicted are prescribed the medication.
  • Benzodiazepines have caused about 8,000 deaths in 2014 in the United States alone.

Other safety information

  • There is little evidence that shows benzodiazepines are helpful for treating PTSD and may even worsen symptoms.
  • Alcohol should NOT be used when taking benzodiazepines.

What if I am taking a benzodiazepine and want to stop?

If a person has been taking a benzodiazepines for a long time they can develop dependence. When this happens stopping the medication suddenly can cause withdrawal and you can experience tremors, sweating, upset stomach, vomiting, headaches, muscle pain, heart problems, seizures, and even death.

If the prescriber stops a benzodiazepine, the dose should be slowly lowered over weeks to months to reduce the likelihood of withdrawal symptoms.

 

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©2019 The College of Psychiatric and Neurologic Pharmacists (CPNP). Shedrick Martin, PharmD, February 2019

This information is being provided as a community outreach effort of the College of Psychiatric and Neurologic Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the topic. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The College of Psychiatric and Neurologic Pharmacists disclaims any and all liability alleged as a result of the information provided herein. CPNP makes this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. Last Updated: January 2016.​

To view the references for this resource, please visit cpnp.org/390124.