What Are Benzodiazepines?

bottles of pills benzos benzodiazepines
Benzodiazepines can be short or long acting.Getty Images
Benzodiazepines are depressant or sedative drugs. Doctors use them to treat anxiety, insomnia, and muscle spasms, but these drugs carry a risk of dependence. Read on to learn more about the conditions they treat, the different types, and how they work.

What Are Benzodiazepines?

Benzodiazepines slow the action of your brain and nervous system and relax your muscles. They’re useful for treating anxiety, epilepsy, and insomnia.

Drugs that slow the brain and nervous system are called depressants or sedatives. Benzodiazepines are also psychoactive drugs because they affect how your brain works and how you feel.

These drugs are highly restricted due to the risk of dependence and severe side effects, especially if you use them with alcohol or another sedative.

What Conditions Do Benzodiazepines Treat?

Doctors prescribe benzodiazepines for the following conditions:

?
  • Anxiety disorder
  • Panic disorder
  • Insomnia
  • Seizures
  • Epilepsy
  • Catatonia, when the body becomes rigid or unable to move due to a mental health problem, such as bipolar disorder
  • Alcohol withdrawal
  • Benzodiazepine withdrawal
Doctors may use remimazolam (Byfavo)?to sedate a person during a surgical procedure lasting less than 30 minutes.

Which benzodiazepine a doctor prescribes depends on why you need it.

For instance, clonazepam (Klonopin)?is effective for seizures, but temazepam (Restoril)?is better for managing insomnia.

Some people use benzodiazepines for several months or longer, but the longer you use them, the higher the risk of dependence or addiction.

Types of Benzodiazepines

Benzodiazepines can be short or long acting.

Short-Acting Benzodiazepines

These drugs are useful for managing acute situations such as a panic attack or insomnia. They work quickly and last for only a limited time.

Some short-term options start working more quickly than others.

Triazolam (Halcion) is one of the fastest drugs to take effect. Temazepam and lorazepam (Ativan) take longer, and oxazepam (Serax) takes the longest.

Long-Acting Benzodiazepines

The effects of these drugs may take longer to appear but also last longer. They may help manage both insomnia and daytime anxiety.

Diazepam (Valium)?takes effect fastest. Taken by mouth, it starts working after 50 to 60 minutes and lasts around 12 hours. When injected, however, the drug takes only one to three minutes to have an effect.

In comparison, chlordiazepoxide (Librium)?has a medium onset, and flurazepam (Dalmane)?has a slow onset.

How Do Benzodiazepines Work?

Benzodiazepines activate proteins known as benzodiazepine receptors in the central nervous system (CNS). This increases the level of a brain chemical called GABA.


The increased GABA slows down and relaxes the muscles and other functions. For this reason, benzodiazepines are also known as depressants.

Other examples of depressants include alcohol and opioids.

Taking benzodiazepines can help you feel:

  • Calm
  • Relaxed
  • Sleepy

That said, they can have other effects, too.

What Are the Possible Side Effects of Benzodiazepines?

Benzodiazepines can be useful, but they can also have unwanted and sometimes dangerous side effects:


  • Shallow breathing
  • Drowsiness
  • Confusion
  • Headache
  • Lightheadedness and fainting
  • Weakness
  • Fatigue
  • Hallucinations
  • Nausea
  • Vomiting
  • Diarrhea
  • Tremors
  • Loss of balance with a risk of falling
  • Vision changes or difficulty focusing the eyes
  • Low blood pressure
  • A risk of accidents when using machinery
  • Difficulty thinking, remembering things, or making decisions

Taking too much or combining a benzodiazepine with another depressant such as alcohol can intensify the effects.

It can slow your breathing so much that your brain doesn’t get enough oxygen. This can result in seizures, coma, or death.

It’s essential to always follow your doctor’s instructions when using benzodiazepines. You should also make sure your doctor knows about any other medications or substances you are using. Remember to mention any natural remedies, pain relief, and alcohol intake as well.

Are There Any Risks Related to Benzodiazepines?

Benzodiazepines are associated with various risks: They are highly regulated, carry a boxed warning, and are available only by prescription.

Dependence and Withdrawal

Extended use of benzodiazepines can lead to physical dependence. If this happens, you’ll need a higher dose for the same effect. Stopping suddenly can lead to symptoms similar to those of alcohol withdrawal.

Symptoms of withdrawal, which can last one to two weeks, include the following:

  • Irritability and excitability
  • Disturbing dreams
  • Insomnia
  • Panic attacks
  • Depression
  • Paranoid thoughts
  • Social phobia
  • Difficulty thinking and focusing
  • Delirium and possibly psychosis
  • Headaches
  • Seizures
  • Physical pain and stiffness
  • Tremors
  • Changes to appetite and digestion
Tell your doctor if you are ready to stop using benzodiazepines. They will guide you through the process of tapering off the drugs. Experts note that 1 in 4 people who use benzodiazepines for six months or longer may experience withdrawal, even if they have followed their prescription correctly.

The risk of withdrawal appears to be higher with shorter-acting drugs, stronger prescriptions, and longer use.

Risks of Long-Term Use

Some research suggests that long-term benzodiazepine use may permanently affect the brain and nervous system.

In older people, particularly, it may increase the risk of these issues:

  • Thinking problems
  • Dementia
  • Reduced sensory skills
  • Movement problems due to impaired motor function
  • Aggressive behavior

Drug of Abuse

Some people use benzodiazepines as recreational drugs, potentially with hazardous consequences. Street names include benzos, downers, and tranks.

Flunitrazipam (Rohypnol) is used to induce euphoria. Street names include forget-me pill, circles, and Wolfies. But one person may give another person the drug without them realizing it, then carry out a sexual assault while the drugged person is unable to react due to sedation. The drugged person will not remember what happened.

Taking an unknown quantity of this drug, particularly with alcohol, can be fatal.

Interactions

Using benzodiazepines with other CNS depressants increases the effects of benzodiazepines. This can have severe and possibly life-threatening consequences.

Other depressants include these examples:

Individual Considerations

Some people are more susceptible to the effects of benzodiazepines:

  • Older people
  • Those using opioids
  • People with some types of glaucoma
  • Anyone with a history of an adverse reaction
  • People who are pregnant or breastfeeding

Specific benzodiazepines may have other considerations and contraindications. A doctor will take these into account when assessing whether to prescribe benzodiazepines.

The Takeaway

Benzodiazepines are a type of drug known as a depressant or sedative. They are considered psychoactive since they affect how the brain works. Benzodiazepines boost the level of a chemical called GABA, which reduces brain and CNS activity. This can lead to a feeling of relaxation, making benzodiazepines useful for treating anxiety, insomnia, and seizures. However, they can also have severe and potentially life-threatening adverse effects. It’s essential to follow your doctor’s guidance when using these drugs and when quitting.

Resources We Trust

  • Cleveland Cinic: Benzodiazepines (Benzos)
  • Mayo Clinic: Diazepam (Oral Route)
  • StatPearls: Benzodiazepines
  • U.S. Drug Enforcement Administration: Benzodiazepines
  • Australian Prescriber: Management of Benzodiazepine Misuse and Dependence
Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

  1. Edinoff AN et al. Benzodiazepines: Uses, Dangers, and Clinical Considerations. Neurology International. November 2021.
  2. Bounds CG et al. Benzodiazepines. StatPearls. January 30, 2024.
  3. Benzodiazepines. Health Research Board.
  4. Dhaliwal J et al. Diazepam. StatPearls. August 28, 2023.
  5. Rohypnol. U.S. Drug Enforcement Administration.
Show Less

Angela D. Harper, MD

Medical Reviewer

Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adults.??

A distinguished fellow of the American Psychiatric Association, Dr. Harper has worked as a psychiatrist throughout her career, serving a large number of patients in various settings, including a psychiatric hospital on the inpatient psychiatric and addiction units, a community mental health center, and a 350-bed nursing home and rehab facility. She has provided legal case consultation for a number of attorneys.

Harper graduated magna cum laude from Furman University with a bachelor's degree and cum laude from the University of South Carolina School of Medicine, where she also completed her residency in adult psychiatry. During residency, she won numerous awards, including the Laughlin Fellowship from the American College of Psychiatrists, the Ginsberg Fellowship from the American Association of Directors of Psychiatric Residency Training, and resident of the year and resident medical student teacher of the year. She was also the member-in-training trustee to the American Psychiatric Association board of trustees during her last two years of residency training.

Harper volunteered for a five-year term on her medical school's admission committee, has given numerous presentations, and has taught medical students and residents. She currently supervises a nurse practitioner. She is passionate about volunteering for the state medical board's medical disciplinary commission, on which she has served since 2015.

She and her husband are avid travelers and have been to over 55 countries and territories.

Yvette Brazier

Author

Yvette Brazier's career has focused on language, communication, and content production, particularly in health education and information. From 2005 to 2015, she supported learning in the health science department of a higher education establishment, teaching the language of health, research, and other language application skills to paramedic, pharmacy, and medical imaging students.

From 2015 to 2023, Yvette worked as a health information editor at Medical News Today and Healthline. Yvette is now a freelance writer and editor, preparing content for Everyday Health, Medical News Today, and other health information providers.

See Our Editorial PolicyMeet Our Health Expert Network
xxfseo.com