Benzodiazepines

Benzodiazepines are prescribed to treat many conditions including severe anxiety, alcohol withdrawal symptoms and muscle spasms. Doctors usually prescribe them for a short time and only if other treatment isn't working.

Benzodiazepines available in New Zealand
  • Alprazolam (Xanax®)
  • Diazepam        
  • Lorazepam (Ativan®)
  • Zopiclone *
  • Midazolam (Hypnovel®)
  • Oxazepam (Ox-Pam®)
  • Temazepam (Normison®)
  • Clonazepam (Paxam®)
* Zopiclone is not a true benzodiazepine but it acts in a similar way to help with sleep problems (insomnia).

What conditions are benzodiazepines used for?

Benzodiazepines have a calming, relaxing effect, and 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 you during certain medical procedures or operations
  • to reduce the symptoms of alcohol withdrawal if you have stopped drinking
  • muscle spasms, to help relax your muscles
  • epileptic fits (seizures) if a quick effect is needed.

Are benzodiazepines safe to take?

Benzodiazepines can be highly addictive and should only be used for a short time. 

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

  • Your body gets used to benzodiazepines quickly and after 2–4 weeks it's unlikely they will have the same effect. 
  • This doesn't happen if you take benzodiazepines every now and again, or for less than 2–4 weeks. 
  • If you take a benzodiazepine every day for longer than about 2–4 weeks, you may feel dependent on it. You may get withdrawal effects if you stop suddenly and the feelings of anxiety may be worse.

If you have been using benzodiazepines every day for a long time, your doctor could recommend you reduce your dose gradually when it is time to stop taking it. This is to reduce the risk of withdrawal effects.

How to use benzodiazepines safely

You need to take extra care when taking benzodiazepines because they 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 medicine. 
  • Taking other medicines
    • Taking some other medicines (such as antihistamines, antidepressants or pain relief medicines) 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 medicine affects you, especially when you first start treatment.
    • 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) NZ Formulary Patient Information
Lorazepam NZ Formulary Patient Information 
Benzodiazepines 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, NZ, 2015
  2. Hypnotics – benzodiazepines NZ Formulary 
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland, and Dr Helen Kenealy, General Physician and Geriatrician, Counties Manukau DHB Last reviewed: 22 Apr 2021