Benzodiazepines — Withdrawal and Side Effects

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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.

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