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- What are benzodiazepines, and how do they work (mechanism of action)?
- What are the uses for benzodiazepines?
- What are the side effects of benzodiazepines?
- Can you drink with benzodiazepines?
- Can you get addicted to benzodiazepines?
- What are the withdrawal symptoms and signs for benzodiazepine dependence?
- What are all the types of benzodiazepines?
- Formulations of benzodiazepines
- Is it safe to take benzodiazepines if I'm pregnant or breastfeeding my baby?
What are benzodiazepines, and how do they work (mechanism of action)?
Benzodiazepines are man-made medications that cause mild to severe depression of the nerves within the brain (central nervous system) and sedation (drowsiness).
Seizures, anxiety, and other diseases that require benzodiazepine treatment may be caused by excessive activity of nerves in the brain. These drugs may work by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. Gamma-aminobutyric acid is a neurotransmitter, a chemical that nerves in the brain use to send messages to one another. Gamma-aminobutyric acid reduces the activity of nerves in the brain and increasing the effect of GABA with a benzodiazepine, reduces brain activity.
What are the uses for benzodiazepines?
Adult men and women use benzodiazepines to treat:
- Panic disorders
- Muscle spasms
- Alcohol withdrawal
- Status epilepticus (A life-threatening disorder of the brain.)
- Premenstrual syndrome
Other uses for benzodiazepines
These medications also are used for:
- Sedation during surgery
- The treatment various types of anxiety disorders, for example:
Benzodiazepine drugs (also called benzos) are habit forming and can lead to addiction. Long-term use also can lead to tolerance, which means that lower doses will become ineffective and patients will need higher doses. These drugs are abused to get 'high' due to their effects on the brain.
What are the side effects of benzodiazepines?
Common side effects include:
- Memory impairment
- Improper body balance
- Increase or decrease in appetite
- Weight gain
- Dry mouth
- Reduced libido
Serious side effects include:
Can you drink with benzodiazepines?
No. Combining alcohol with a benzodiazepine is very dangerous. People who drink alcohol while taking this medicine will feel the effects of alcohol faster. It's not safe to drink alcohol or take other drugs that have similar effects on the central nervous system (CNS) at the same time because these drugs or substances interact with oral benzodiazepines by causing additional depression of the brain and respiratory depression. Respiratory depression can lead to breathing that's inadequate for supplying oxygen to the body. This can cause death. Examples of these drugs and products that increase sedative side effects or the risk of respiratory depression from benzodiazepines include:
Pain medications called opioids that also cause respiratory depression, for example:
- morphine (MScontin)
- fentanyl (Duragesic)
- oxycodone (Oxycontin)
- hydrocodone (Zohydro ER)
- acetaminophen/hydrocodone (Vicodin, Norco, Lorcet)
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Can you get addicted to benzodiazepines?
Yes, benzodiazepines or benzos are habit forming and you can become addicted to them - even if you take them as your doctor or health care professional has prescribed. People who have a history of drug or alcohol abuse are more likely to develop an addiction to these drugs. If you use these drugs over a long period of time you can develop a tolerance for them. This means that you will need higher doses of the drug to treat your health condition or disease because you've become tolerant of the weaker formulations of the drug. These drugs may be very effective for the treatment of several conditions, for example, anxiety and insomnia; but be careful because you can become addicted to them.
The street names for benzodiazepine drugs are "Benzos" and "Downers." Drug addicts abuse these drugs to get "high." They can cause addiction similar to opioids (narcotic drugs like oxycodone, morphine, hydrocodone, and fentanyl), cannabinoids (marijuana), and the club drug GHB (gamma-hydroxybutyrate).
They are commonly abused by young adolescents and young adults who crush it up and snort it, or take the tablet to get high. If you abuse this medication you may have adverse effects with symptoms include:
- Disturbing or vivid dreams
Signs and symptoms that you might be addicted include:
It is very difficult to recover from benzodiazepine addiction because these drugs change the chemistry of the brain. Contact a drug addiction treatment center if you or a loved one are suffering from a addiction. Quitting cold turkey is not likely to be successful and can be dangerous because of symptoms of withdrawal. Doctors and other health care professionals that treat addiction will formulate a taper schedule to slowly wean off the medication to reduce the severity of withdrawal symptoms during treatment.
Signs and symptoms of overdose include:
What are the withdrawal symptoms and signs for benzodiazepine dependence?
If you stop taking these medications abruptly you may experience withdrawal symptoms that include:
- Problems concentrating
- Sleep problems
- Increased anxiety and tension
- Panic attacks
- Hand tremors
- Dry heaving and vomiting
- Muscle pain and stiffness
- A host of perceptual changes
The severity of the withdrawal symptoms depends on amount and duration of benzodiazepine use. Withdrawal symptoms can be deadly.
These medications are classified by the Drug Enforcement Administration (DEA) as Schedule IV drugs. This means that they have a lower potential and risk of dependence than other more powerful drugs like codeine, testosterone, anabolic steroids, Vicodin (hydrocodone and acetaminophen), OxyContin (oxycodone), Adderall (amphetamine and dextroamphetamine), and Ritalin (methylphenidate).
What are all the types of benzodiazepines?
Examples of oral benzodiazepines are:
- alprazolam (Xanax, Xanax XR)
- clobazam (Onfi)
- clonazepam (Klonopin)
- clorazepate (Tranxene)
- chlordiazepoxide (Librium)
- diazepam (Valium, Diastat Acudial, Diastat)
- estazolam (Prosom is a discontinued brand in the US)
- lorazepam (Ativan)
- oxazepam (Serax is a discontinued brand in the US)
- temazepam (Restoril)
- triazolam (Halcion)
Formulations of benzodiazepines
All oral benzodiazepines are available in tablet forms.
- Alprazolam and clorazepate are available as extended-release tablets.
- Alprazolam, clobazam, diazepam, and lorazepam are available in oral liquid form.
- Alprazolam and clonazepam are available in orally dissolving tablets.
- Chlordiazepoxide, oxazepam, and temazepam are available in capsule form.
- Diazepam also is available as a rectal gel.
- Some benzodiazepines are available for injection.
Is it safe to take benzodiazepines if I'm pregnant or breastfeeding my baby?
- The FDA classifies benzodiazepines as pregnancy category D, which means that benzodiazepines can potentially cause fetal harm if administered to pregnant women. If benzodiazepines have to be used in pregnant women or if the patient may become pregnant while taking benzodiazepines, the patients must be informed of potential risks to the fetus.
- Benzodiazepines enter breast milk and can cause lethargy and weight loss in the newborn. Therefore, they should not be used in nursing mothers.
Benzodiazepine is the name of a class of drugs in the US. They belong to a class of man-made drugs prescribed to treat anxiety, nervousness, panic attacks, seizures, muscle spasms, and insomnia. Lorazepam (Ativan), alprazolam (Xanax), and diazepam (Valium) are examples of benzodiazepines.
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Related Disease Conditions
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
7 Reasons You Are Tired After Surgery
Postsurgical fatigue is normal and is due to a variety of factors. Depression, stress, and anxiety may produce fatigue. Sleep deficits, certain medications, anemia, blood loss, fasting, and loss of electrolytes and minerals associated with surgery can also produce fatigue. Exercise, physical exertion, aging, and the overall health status of patients are additional factors that play a role in making people feel tired after surgery.
Anxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
Seizures Symptoms and Types
Seizures are divided into two categories: generalized and partial. Generalized seizures are produced by electrical impulses from throughout the brain, while partial seizures are produced by electrical impulses in a small part of the brain. Seizure symptoms include unconsciousness, convulsions, and muscle rigidity.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizziness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Sleep Disorders (How to Get a Good Night's Sleep)
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. The National Institutes of Health recommend about 7-9 hours of sleep each night for older, school-aged children, teens, and most average adults; 10-12 for preschool-aged children; and 16-18 hours for newborns. There are two stages of sleep; 1) REM sleep (rapid-eye movement), and 2) NREM sleep (non-rapid-eye movement). The side effects of lack of sleep or insomnia include: Irritability Tiredness Feeling sleepy during the day Concentration or memory problems Lack of sleep and insomnia can be caused by medical conditions or diseases, medications, stress, or pain. The treatment for lack of sleep and insomnia depends upon the cause.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Sleep: A Dynamic Activity
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Tardive dyskinesia occurs after exposure to certain types of medication. The most common medications that can lead to tardive dyskinesia include antipsychotic medications and antiemetics. Symptoms associated with tardive dyskinesia include tongue protrusion, lip pursing or smacking, grimacing, cheek bulging or puffing out, chewing actions, and eye closure. Early diagnosis and treatment of tardive dyskinesia are often successful in controlling the symptoms and even reversing the condition.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Teen Drug Abuse
Drugs commonly abused by teens include tobacco products, marijuana, cold medications, inhalants, depressants, stimulants, narcotics, hallucinogens, PCP, ketamine, Ecstasy, and anabolic steroids. Some of the symptoms and warning signs of teen drug abuse include reddened whites of eyes, paranoia, sleepiness, excessive happiness, seizures, memory loss, increased appetite, discolored fingertips, lips or teeth, and irritability. Treatment of drug addiction may involve a combination of medication, individual, and familial interventions.
Insomnia Treatment (Sleep Aids and Stimulants)
Insomnia is difficulty in falling or staying asleep, the absence of restful sleep, or poor quality of sleep. Insomnia is a symptom and not a disease. The most common causes of insomnia are medications, psychological conditions, environmental changes and stressful events. Treatments may include non-drug treatments, over-the-counter medicines, and/or prescription medications.
Why Do People Sleepwalk (Somnambulism)?
Sleepwalking is a condition in which an individual walks or does other activities while asleep. Factors associated with sleepwalking include genetic, environmental, and physiological. Episodes of sleepwalking may include quiet walking to agitated running. Conditions that may have similar symptoms of sleepwalking, but are not include night terrors, confusional arousals, and nocturnal seizures. Treatment of sleepwalking generally include preventative measures. Medication may be prescribed if necessary.
Mental health is an optimal way of thinking, relating to others, and feeling. All of the diagnosable mental disorders fall under the umbrella of mental illness. Depression, anxiety, and substance-abuse disorders are common types of mental illness. Symptoms and signs of mental illness include irritability, moodiness, insomnia, headaches, and sadness. Treatment may involve psychotherapy and medication.
Spinal Muscular Atrophy (SMA)
Spinal muscular atrophy (SMA) is an inherited (genetic) disease that attacks motor neurons (nerve cells) in the spinal cord. As the nerve cells die, muscle cells weaken and cause signs and symptoms that affect head and neck control, walking, crawling, breathing, and swallowing. There are numerous types of spinal muscle atrophy. Treatments for spinal muscle atrophy are directed at managing symptoms of the disease. There is no cure for spinal muscle atrophy, and some types cause death.
Agoraphobia is a fear of being outside or of being in a situation from which escape would be impossible. Symptoms include anxiety, fear, disorientation, rapid heartbeat, diarrhea, or dizziness. Treatment may incorporate psychotherapy, self-exposure to the anxiety-causing situation, and medications such as SSRIs, benzodiazepines, and beta-blockers.
Sleep Disorders in Children and Teenagers
Sleep needs in children and teenagers depend on the age of the child. Sleep disorders in children such as: sleep apnea, parasomnias, confusional arousals, night terrors, nightmares, narcolepsy, and sleepwalking which can affect a child's or teen's sleep. Healthy sleep habits and good sleep hygiene can help your infant, toddler, preschooler, tween, or teenager get a good night's sleep.
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Restless Leg Syndrome is an often uncontrollable urge to twitch and move your legs – especially when sitting or lying down. It isn’t curable and the cause is unclear, but it’s a neurological problem that researchers theorize may result from a lack of iron in the brain or a physiological in processing and using iron.
Mental illness is any disease or condition affecting the brain that influence the way a person thinks, feels, behaves, and/or relates to others. Mental illness is caused by heredity, biology, psychological trauma and environmental stressors.
When sleepiness interferes with daily routines and activities, or reduces the ability to function, it is called "problem sleepiness." A person can have problem sleepiness without realizing it. Symptoms of problem sleepiness include: consistently don't get enough sleep, or poor quality sleep, fall asleep while driving, struggle to stay awake when inactive (like watching TV or reading), have difficulty paying attention or concentrating at work, school, or home, have poor performance problems at work or school, have difficulty remembering things, have slowed responses, have difficulty controlling your emotions, and/or if you have to take naps on most days.
Pregnancy and Drugs (Prescription and OTC)
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.
Treatment & Diagnosis
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Medications & Supplements
- Anxiolytics (for Anxiety) Drug Class Side Effects
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- chlordiazepoxide (Librium)
- triazolam (Halcion)
- temazepam (Restoril)
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- Valium (diazepam) vs. midazolam
- Ativan vs. Xanax
- Belsomra (suvorexant)
- clobazam - oral, Onfi
- clorazepate - oral, Tranxene
- oxazepam (Serax, Zaxopam)
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CESAR, Center for Substance Abuse Research, University of Maryland. "Benzodiazepines."
Drug Enforcement Administration. "Drug Fact Sheet; Benzodiazepines."
Drug Enforcement Administration. "Drug Schedules."
FDA Prescribing Information.
National Institute on Drug Abuse; Advancing Addiction Science. "Like opioids and cannabinoids, diazepam and other benzodiazepines take the brakes off activity of dopamine-producing neurons.." Updated Apr 19, 2012.
National Institute on Drug Abuse; Advancing Addiction Science. "Heroin." Updated: Jan 2017
Petursson, H. "The benzodiazepine withdrawal syndrome." Addiction. 1994 Nov;89(11):1455-9.