What are benzodiazepines?
Benzodiazepines are a group of prescription-only medicines that have a sedating and calming effect on the brain and nervous system. They are also known as sedatives or tranquillisers. Examples of benzodiazepines include medicines containing one of the following active ingredients: diazepam, lorazepam, oxazepam, temazepam and alprazolam.
They come in tablet and capsule form, and some are available for intravenous use in hospital settings.
How do benzodiazepines work?
Benzodiazepines differ in how quickly the active ingredient starts to work and how long the effect lasts. The effect of the medicine also depends on the prescribed dose, and on the individual (eg height, weight, health status and previous experience with benzodiazepines), which can impact on how the medication will work.
Benzodiazepines can help treat symptoms of anxiety and sleeping problems (eg insomnia). As non-medicine therapies have proven benefit in these conditions, benzodiazepines are generally considered only if these options are inappropriate or have failed.
If you have been diagnosed with an anxiety disorder, benzodiazepines can make you feel calmer. If you have insomnia, benzodiazepines may help you fall asleep. They are sometimes used for other reasons, such as a medication before an operation to alleviate nervousness.
After taking benzodiazepines, people can describe feeling drowsy, relaxed, confused/fuzzy and having a heavy sensation in their arms and legs. Coordination and reflexes can be effected too, which means you should not take benzodiazepines if you need to be focused and coordinated (eg drive a car or operate heavy machinery).
Benzodiazepines are usually taken for a set period until the intended therapeutic effect is achieved. Then, the dose is reduced and plans to stop it are made.
If you take benzodiazepines for a prolonged time, the body may adapt and get used to the effects of the medication. Stopping the medication can lead to withdrawal symptoms that includes anxiety and restlessness. Withdrawal symptoms are often mild, but can be severe if you are on high doses of a benzodiazepine. Serious side effects, including seizures, can occur if you stop taking high doses suddenly.
Can benzodiazepines be addictive?
Although addiction (cravings, abuse, misuse, compulsive or uncontrollable benzodiazepine-seeking behaviour) is possible with benzodiazepines, it is rare in people who are taking therapeutic doses for a specific reason over a short period as prescribed by their doctor.
You may be at a greater risk of developing an addiction to benzodiazepines if you have a history of drug dependence, or if you are currently misusing any substance including alcohol or strong pain killers (opioid drugs).
Before prescribing a benzodiazepine, your doctor will ask you questions about these sorts of things to help prevent addiction.
What are the possible side effects of benzodiazepines?
Benzodiazepines are associated with a number of side effects including:
- drowsiness and unsteadiness, potentially increasing the risk of a fall
- mpairment in judgement and dexterity, making tasks such as driving or using heavy machinery more difficult
- forgetfulness, confusion, irritability
- paradoxical aggression and excitability (although this is rare, it is the opposite effect to what is expected with these medicines).
Taking benzodiazepines in combination with other drugs or alcohol can be very dangerous, and in some cases fatal.
Can I take benzodiazepines for a long time?
Benzodiazepines are usually taken for a short length of time. In rare instances, some patients will require long-term therapy with benzodiazepines. This is after a serious consideration of risks and benefits of long-term therapy between you and your doctor. If you and your doctor have decided that benzodiazepines are an important part of your long-term treatment, then you should continue to take them as prescribed and keep checking in with your doctor for review.
If you have been taking benzodiazepines regularly for longer than 4 weeks and wish to stop them, your doctor would be happy to advise you on how to do this. Do not stop or significantly alter the dose abruptly. Many people can stop taking benzodiazepines without difficulty. For others, gradual reduction helps prevent or reduce any withdrawal symptoms.
Where can I get more information?
Reconnexion, an Australian not-for-profit organisation that offers programs, counselling, telephone information and support for people with anxiety, stress, depression and benzodiazepine dependence and related conditions.
• The Victorian Government’s Better Health Channel website
• The Australian Drug Foundation’s help and support page lists sources of information and advice.
* Kenny T, Harding M. Benzodiazepines and Z Drugs [Internet]. London: patient.co.uk; 2014 [updated October 2014]. [Accessed 11 June 2015].