Benzodiazepines: Risks and Benefits

Drug Class

  • Sedatives
  • Hypnotics
  • Anxiolytics

How common is benzodiazepine use?

Prescribing of hypnotic and anxiolytic drugs is increasing. In 2011-12 more than 16 million prescriptions for these drugs were written in general practice in England.

What medical conditions are treated with benzodiazepines?

Benzodiazepines are prescribed for management of:

  • anxiety disorders
  • panic disorders
  • treatment of seizure
  • treatment of symptoms of alcohol
  • treatment of GHB withdrawal
  • poor sleep
  • prevention of panic attacks prior to dentist visits or diagnostic procedures
  • Muscle relaxation

Because of their addictive potential these medications are prescribed only for a short period of time.


Benzodiazepines are gamma-aminobutyric acid (GABA) receptor agonists

Benzodiazepines are commonly divided into three groups based on their half-life in blood:

  • Short-acting
    • half-life less than 12 hours
    • Examples: midazolam and triazolam.
  • Intermediate-acting
    • half-life between 12 and 24 hours
    • Examples: alprazolam, lorazepam, and temazepam.
  • Long-acting
    • half-life greater than 24 hours
    • Examples: diazepam, clonazepam, clorazepate, chlordiazepoxide, and flurazepam.

Adverse Effects

Regular use of benzodiazepins increases the risk of:

  • Seizure
  • Rebound anxiety
  • Tremors
  • Poor memory
  • Depression
  • Psychosis
  • Psychomotor impairments
  • Daytime fatigue
  • Ataxia
  • Falls
  • Pneumonia, and other infections

Who should not use benzodiazepines?

Patients have to avoid using Benzodiazepines if they have any of the following conditions:

  • current or past history of substance abuse
  • are pregnant
  • are being treated with opioids for chronic pain or replacement therapy for narcotic addiction
  • have medical and mental health problems that may be aggravated with benzodiazepines, such as
    • ADHD
    • bipolar disorders
    • depression
    • fibromyalgia/chronic fatigue syndrome
    • impulse disorders
    • somatization disorders
  • asthma or COPD
  • sleep apnea
  • congestive heart failure


Regular and long term use of these medications could result in dependence. Taking benzodiazepines with narcotic pain killers, opioids, alcohol and GHP could result in sever respiratory depression and death. Benzodiazepines affect cognitive function and reaction time. Avoid driving or operating machinery if you have been started on benzodiazepines recently.


Take benzodiazepines if only they are prescribed to your own medical condition.

Take your pills as prescribed. Do now overuse them.

Tell your doctor if you drink alcohol or use other sedative drugs such as heroin, fentnayl, codeine, morphine, oxycodone, percocet, methadone, suboxone, tramadol…


This document is prepared by the “Mental Health for All” team. This document is provided for information purposes only and does not necessarily represent endorsement by or an official position of the Essentials of Medicine. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.


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