Benzodiazepines are a class of drugs that can treat a range of conditions. Doctors often prescribe them to treat anxiety, seizures, and insomnia.

The short-term use of these medications is usually safe and effective, but long-term use can lead to tolerance, dependence, and other adverse effects.

There are different types of benzodiazepines, and they have different uses. They include:

Taking too much of a benzodiazepine can be dangerous, and mixing it with alcohol or other substances can be fatal.

This article looks at how benzodiazepines work, their uses, and the related side effects and risks.

Benzodiazepines alter the activity of the neurons that trigger stress and anxiety reactions. The Food and Drug Administration (FDA) have approved them for the treatment of:

The type of benzodiazepine will determine the potential uses. Doctors may also prescribe these drugs off-label for various other conditions and issues, including:

They may also use them in preparation for some medical procedures.

Benzodiazepines work by enhancing the effect of a neurotransmitter known as gamma-aminobutyric acid, or GABA.

Neurotransmitters are chemicals that communicate messages between brain cells. These messages can have either a stimulating or a calming effect. GABA is a neurotransmitter that sends calming messages to the body.

When a person feels anxious, overstimulation occurs in the brain. When people take benzodiazepines, the brain will send messages to counter this overstimulation. This activity can reduce the symptoms of anxiety.

There are many different benzodiazepines. They differ in terms of potency, how quickly the body absorbs them, and their uses.

This table shows some examples and their uses:

NameUse
alprazolam panic and anxiety disorders
chlordiazepoxide (Librium)alcohol withdrawal and anxiety
diazepampanic attacks, restless leg syndrome, insomnia, seizures, and alcohol withdrawal
flurazepam (Dalmane)insomnia
clonazepampanic disorder and seizure disorders
lorazepamanxiety, seizures, and anesthesia
temazepam (Restoril)insomnia

The side effects of benzodiazepine use may include:

  • drowsiness
  • confusion
  • dizziness
  • impaired coordination, increasing the risk of falls and accidents
  • depression
  • increased anxiety

More serious effects include:

  • memory problems
  • behavioral changes — for example, increased risk taking
  • delirium, especially in older people
  • risk of dependence, especially with long-term use
  • possibly an increased risk of dementia, although scientists are unsure of this

A wide range of withdrawal symptoms can occur when stopping benzodiazepines. They include:

  • anxiety and panic
  • agitation and restlessness
  • tremors
  • dizziness
  • fatigue
  • sleep problems
  • shortness of breath
  • sweating
  • flushing
  • tremors
  • muscle cramps
  • seizures
  • hallucinations
  • gastrointestinal problems
  • feelings of unreality
  • headaches and muscle pain

Experts do not recommend using benzodiazepines for more than 2 weeks.

A person who uses them for 3–4 weeks and then stops suddenly is likely to experience withdrawal symptoms. People who use them in the long term may need to withdraw their use over a 3–12 month period that their doctor should oversee.

It is essential to follow the doctor’s instructions for stopping the use of these drugs. Stopping slowly with professional help can prevent unwanted effects.

What happens when you stop taking benzodiazepines? Find out here.

Overdose

A benzodiazepine overdose can lead to:

  • extreme sedation or drowsiness
  • a very low breathing rate
  • confusion and difficulty thinking
  • slurred speech
  • loss of muscle control
  • a coma

It can be fatal if a person:

  • uses the drugs with alcohol or opioids
  • is older and takes too much of the drug
  • is taking other drugs, and the effects build up in their body

Anyone who shows signs of an overdose or an adverse reaction after taking benzodiazepines will need emergency medical help.

Before starting treatment with benzodiazepines, a person must tell their doctor about every other medication that they are using.

Some drugs may intensify the effects of benzodiazepines, while others may make them less effective.

It is essential not to use benzodiazepines with opioids or alcohol, as this can lead to life threatening effects.

People should also never combine them with cannabis use.

Benzodiazepine misuse is a cause for concern. Some people use these drugs for recreational purposes without the supervision of a medical professional, which can be dangerous.

People can avoid potentially life threatening problems by:

  • using these drugs only if a doctor prescribes them
  • telling the doctor about any medications or other substances, including supplements, that they are taking
  • following the doctor’s instructions precisely
  • avoiding using the drugs for longer than the doctor prescribes
  • asking the doctor before changing the dosage
  • refraining from using them alongside alcohol or opioids
  • refraining from using another person’s drugs
  • keeping all drugs out of the reach of children
  • considering asking the doctor about alternative options

Benzodiazepines can help treat some mental health and neurological conditions, but it is essential to use them with care.

A person should always tell their doctor about any other drugs that they are using and seek medical help at once if any unexpected reactions occur.

Anyone who has concerns about their prescription for a benzodiazepine can ask their doctor about alternative options.