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.

Examples of benzodiazepines

Benzodiazepines available in New Zealand include:

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

Although zopiclone is not a true benzodiazepine, it acts in a similar way to benzodiazepines to help with sleep problems (insomnia).

August 2020: Notification that oxazepam (Ox-Pam) will no longer be available in New Zealand
Oxazepam (Ox-Pam) will no longer be available in New Zealand. If you are taking oxazepam this means you will need to talk to your doctor about the best option for you. You should not stop taking oxazepam abruptly. Doing so can cause serious side effects. Read more about oxazepam (Ox-Pam) discontinuation. 

What conditions are benzodiazepines used for?

Benzodiazepines have a calming, relaxing effect. They work by reducing the activity of your brain and slowing down messages going between your brain and 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 your 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, 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.

Extra care

Extra care is needed 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 medication. 
  • Other medicines
    • 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 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 Last reviewed: 03 May 2017