Benzodiazepines

Benzodiazepines are prescribed to treat many conditions including severe anxiety and sleep problems. Doctors usually prescribe them for a short time and only if other treatment isn't working.

Examples of benzodiazepines

Examples of benzodiazepines available in New Zealand:

  • alprazolam (Xanax®)
  • diazepam        
  • lorazepam (Ativan®)
  • nitrazepam (Nitrados®)
  • midazolam (Hypnovel®)
  • oxazepam (Ox-Pam®)
  • temazepam (Normison®)
  • clonazepam (Paxam®).

Zopiclone - although zopiclone is not a true benzodiazepine, it act in a similar way to help sleeping.

What conditions are benzodiazepines used for?

Benzodiazepines have a calming, relaxing effect. They work by reducing the activity of the brain and slowing down messages going between the brain and the body. Because of this calming, relaxing effect, they are used to treat a number of conditions, such as.

  • Severe anxiety, agitation or panic attacks if other treatments are not working.
  • Severe insomnia (sleeping problems) if other treatments are not working.  
  • To relax and/or sedate people who are having certain medical investigations or operations.
  • To reduce the symptoms of alcohol withdrawal for people who have stopped drinking.
  • Muscle spasms, to help relax the muscles.
  • Epileptic fits (seizures) if a quick effect is needed.

Are benzodiazepines safe to take?

It is usually safe to take benzodiazepines, as prescribed by your doctor. For anxiety and insomnia, its best to use benzodiazepines for a short time only. Ongoing use for longer than 2 to 4 weeks is not recommended.

  • If you take a benzodiazepine every day for longer than about 2 to 4 weeks, you may feel dependent on it. You may get withdrawal effects if you stop suddenly, and the feelings of anxiety may be worse.
  • Your body gets used to benzodiazepines quickly, and after 2 to 4 weeks, it is unlikely to have the same effect. This does not happen if you take benzodiazepines occasionally every now and again, or for less than 2 to 4 weeks. 
  • If you have been using benzodiazepines everyday for a long time, your doctor could recommend to reduce your dose gradually when it is time to stop taking it. This is to reduce the risk of withdrawal effects.

Extra care

Extra care is needed when taking benzodiazepines because it can cause sleepiness and affect your concentration. 

  • Alcohol
    • Avoid alcohol while you are taking benzodiazepines, especially when you first start treatment. Drinking alcohol while taking benzodiazepines causes severe drowsiness and impaired concentration. if you do drink alcohol, drink only small amounts and see how you feel. Do not stop taking your medication. 
  • Other medication
    • Taking some other medication (such as antihistamines, antidepressants, painkillers) or herbal products with benzodiazepines may make sleepiness and impaired concentration worse. Check with your pharmacist if you are taking other medicines or herbal products. 
  • Driving
    • Benzodiazepines are likely to affect your concentration and ability to drive. Do not drive until you know how the medication affects you, especially when you first start treatment. Also the effects of most benzodiazepines can last into the following day. Read more about driving and medicines.
  • Risk of falls
    • In addition to affecting concentration and causing next-day sleepiness, benzodiazepines can also cause muscle weakness. All these effects puts you at increased risk of falls, especially if you are elderly. Read about preventing falls.

Learn more

The following links provide further information about benzodiazepines. Be aware that websites from other countries may have information that differs from New Zealand recommendations.

Diazepam (injection) New Zealand Formulary Patient Information
Lorazepam New Zealand Formulary Patient Information 
Benzodiazepines NZ Drug Foundation (NZ)
About benzodiazepines Mind (UK)
Sleeping pills and older people: the risks NPS MedicineWise (Australia)
A reduction plan for your sleeping tablets NPS MedicineWise (Australia)

References

  1. Overuse of benzodiazepines: still an issue? BPAC February 2015
  2. Hynotics - Benzodiazepines New Zealand Formulary 
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 03 May 2017