Risks of Benzodiazepines

• Benzodiazepines should be used carefully under close direction of a prescriber.
• Not using benzodiazepines for the right reason or using them for too long can lead to dependence, addiction, severe side effects, or even death.
• Stopping benzodiazepines should be done by slowly lowering the dose over weeks to months with careful direction from a pharmacist or knowledgeable provider to avoid withdrawal symptoms.

Benzodiazepines are medications that lower the activity of the nerves in the brain and cause you to be drowsy.¹

Benzodiazepines work by boosting the effects of gamma-aminobutyric acid (GABA) in the brain.¹ GABA is a chemical that reduces electrical activity in the brain.¹

Benzodiazepines can be used to treat problems such as general anxiety disorder, panic attacks, difficulty sleeping, alcohol withdrawal, and seizures.^1,2,3

• Benzodiazepines are recommended for short-term relief of symptoms such as anxiety or difficulty sleeping.
• Long-term use must be done under close direction of a health care provider³
• These medications should only be used when prescribed for medical treatment.
• Use in people aged 65 and older should be avoided.⁴

Long-term use

• When used in older people for long-term use this can increase the risk of memory problems, drowsiness, falls, and motor vehicle accidents.⁴
• Long-term use can lead to tolerance where the body needs higher doses to get the same benefit as when the medication was first started.² Long-term use may also lead to physical dependance where symptoms develop when the medication is suddenly stopped.

Side effects

• Severe side effects of this medication are trouble breathing, severe drowsiness, slowed heart rate, low blood pressure, and fainting.^1,2
• Some benzodiazepines can last for a long time and build up in the body, which can increase the risk of side effects.⁵
• Benzodiazepines should be used with caution when taking other medications that cause drowsiness, such as opioid pain medications, as this can lead to overdose, hospitalization, and possibly death.

Medication misuse

• Benzodiazepines can lead to severe mental and physical dependance which increases the risk of developing a substance use disorder.⁸
• Benzodiazepines caused approximately 12,209 deaths in 2020 in the United States alone due to overdose.⁹

Other safety information

• There is little evidence that shows benzodiazepines are helpful for managing Post-traumatic Stress Disorder (PTSD) and may even worsen symptoms.
• Alcohol should NOT be consumed when taking benzodiazepines.
• The FDA issued a “Boxed Warning” for all benzodiazepines outlining the danger of abuse, misuse, and addiction. The warning also provides concern related to physical dependence with prolonged use. This is the strictest warning that can be issued for a medication.¹⁰

• Ativan® (lorazepam)
• Xanax® (alprazolam)
• Klonopin® (clonazepam)
• Librium®(chlordiazepoxide)
• Restoril® (temazepam)
• Valium® (diazepam)
• Halcion® (triazolam)

If a person has been taking a benzodiazepine for a long time, they can develop physical dependence. When this happens, stopping the medication suddenly can cause withdrawal and you can experience tremors, sweating, upset stomach, vomiting, headaches, muscle pain, heart problems, seizures, and even death.² It is recommended to slowly taper off the medication by lowering the dose slowly lowered over weeks to months to reduce the likelihood of withdrawal symptoms.¹¹

Stopping benzodiazepines can be complicated and a pharmacist should be consulted along with your prescribing clinician to help develop a plan.

Last Reviewed: September 2024

Provided by

Shedrick Martin, PharmD, February 2024

To view the references for this resource, please visit aapp.org/390124.

Important Disclosure: This information is being provided as a community outreach effort of the American Association of Psychiatric Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the topic. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The American Association of Psychiatric Pharmacists disclaims any and all liability alleged as a result of the information provided herein.

©2024 The American Association of Psychiatric Pharmacists (AAPP). AAPP makes this document available under the Creative Commons Attribution-NoDerivatives 4.0 International License. Last Updated: January 2016.