Benzodiazepines

Benzodiazepines are prescribed to treat anxiety and sleep problems. Doctors often prescribe them for a short time 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.

  • Anxiety, agitation or panic attacks if other treatments are not working.
  • Insomnia (sleeping problems) if other treatments are not working.  
  • To relax and/or sedate people who are having certain medical investigations or operations.
  • The symptoms of alcohol withdrawal in people who have stopped drinking.
  • Muscle spasms - it helps to relax the muscles.
  • The treatment of epileptic fits (seizures) as they are useful where a quick effect is needed.

Are benzodiazepines safe to take?

It is usually safe to take benzodiazepines, as prescribed by your doctor. For conditions like anxiety and insomnia, its best to use benzodiazepines for a short time. Ongoing, continuous 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, it may lead to your feeling dependent on it. You may get withdrawal effects if you stop suddenly, and the feelings of anxiety may be worse.
  • Also, your body gets used to it quickly, and after this time it is unlikely to have the same effect. 
  • This does not happen if you take benzodiazepines occasionally every now and again, or only for less than 2 to 4 weeks. 
  • If you have been using benzodiazepines everyday for a prolonged period, your doctor could recommend that you reduce your dose gradually when it is time to stop taking it. This is to reduce the risk of you experiencing 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 the feelings of sleepiness and impaired concentration worse. Check with your pharmacist if you are taking other medicines or supplements. 
  • Driving
    • Benzodiazepines are likely to affect your concentration and ability to drive. Do not drive until you know how this medication affects you, especially when you first start treatment. Also be aware that 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 on benzodiazepines. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

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. Last reviewed: 11 Apr 2017