Benzodiazepines Side Effects

Benzodiazepines are a depressant class of medication prescribed to treat anxiety, panic disorder, insomnia, seizure disorders, and alcohol withdrawal syndrome. In the short term, benzodiazepines typically don’t have serious enough side effects to be a major concern if only used as prescribed. 

If used for longer than about two to four weeks, their impact on a person’s health can become more serious even as they become less effective in terms of treatment, so they’re not typically prescribed this way if other alternatives are available.

If benzodiazepines are misused, side effects are more likely and may be more severe or dangerous.

Common Benzodiazepines

Commonly prescribed long-acting benzodiazepines include the following:[1]

• Alprazolam (Xanax)
• Chlordiazepoxide (Librium)
• Clorazepate (Tranxene)
• Diazepam (Valium)
• Halazepam (Paxipam)
• Lorazepam (Ativan)
• Oxazepam (Serax)
• Prazepam (Centrax)
• Quazepam (Doral)
• Clonazepam (Klonopin)

Some short-acting benzodiazepines include the following:[1]

• Estazolam (ProSom)
• Flurazepam (Dalmane)
• Temazepam (Restoril)
• Triazolam (Halcion)
• Midazolam (Versed)

Common Side Effects

Benzodiazepines have a number of common side effects associated with them, including these:[2],[4],[7]

• Drowsiness
• Headaches
• Vertigo
• Tremors or uncontrollable shakiness
• Reduced sex drive
• Difficulty concentrating
• Slowed movements and thoughts
• Nausea or vomiting

In many cases, benzodiazepine use can temporarily make the driving or operation of heavy machinery (including cars) unsafe. This is primarily due to a person becoming too drowsy and having difficulty focusing on the road.

Additionally, some people may experience what is known as paradoxical disinhibition. This is when a person experiences benzodiazepines side effects that are the opposite of what’s expected. Instead of sedation or calming, they exhibit aggression, irritability, hostility, and impulsivity. This could lead to violence or other risky behaviors.[4]

Rare Benzo Side Effects

Some rarer side effects of benzodiazepines may include:[6],[7]

• Double vision
• Difficulty focusing on objects
• Liver damage
• Hallucinations
• Tingling or numb feeling
• Loss of balance
• Depression
• Emotional blunting
• Seizures
• Skin rash
• Jaundice (yellowing of eyes or skin)
• Confusion

Overdose: When Side Effects Become Life-Threatening

Because benzodiazepines are central nervous system depressants, they can cause respiratory depression and slowed heart rate. Taking too much of a benzo or mixing benzos with other depressants like alcohol or opioids can lead to a potentially fatal overdose. Signs of a benzodiazepine overdose include:[1]

• Confusion
• Extreme drowsiness or sedation
• Slowed or stopped breathing
• Coma

An overdose is a medical emergency. If you suspect you or someone else has overdosed, call 911 immediately.

Long-Term Health Impact of Benzos

Generally, benzodiazepines are prescribed for short-term use because of their dependence potential, even when taken for a few weeks.

Some other long-term risks of benzodiazepine use include:[3],[4]

• Benzodiazepine addiction
• Tolerance and overdose
• Dependence and withdrawal symptoms
• Amnesia
• Cognitive decline
• Increased risk of car accident

In addition to abuse and dependence risks, benzodiazepines are associated with a number of other serious health and safety risks that have to be weighed against their use. At least one meta-analysis found that diazepam, one commonly prescribed benzodiazepine, can cause cognitive decline that did not resolve three months after discontinuation. [4]

Benzodiazepine use increases a person’s risk of a motor vehicle accident to a degree similar to that of having a blood alcohol content of about 0.05% to 0.079%, depending on the dose and individual. 

In 2019, over 5 million adults reported benzodiazepine abuse, with people between the ages of 18 and 25 having the highest rates of misuse. Plus, abusing prescription opioids and stimulants increased the likelihood of benzodiazepine abuse.[8]

In older adults, benzodiazepine use is associated with a significant risk of hip fracture. Benzodiazepines seem to increase an older person’s risk by at least 1.5 times, with one study showing zolpidem increasing the risk of hip fracture in adults over 65 by about 2.55 times.[9]

Dependence and Withdrawal Symptoms

Benzodiazepine withdrawal can be serious, even life-threatening. A person should not just suddenly stop taking benzodiazepines. Instead, they should work with their doctor to safely taper off the medication.

Abruptly stopping high-dose use is associated with several withdrawal symptoms, including:[4],[6]

• Anxiety
• Insomnia
• Rapid, purposeless movements
• Seizures
• Tremors
• Nausea or vomiting
• Hallucinations
• Sweating
• Rapid pulse

People who are dependent on or addicted to benzodiazepines should not quit cold turkey due to the risk of life-threatening seizures. They should undergo withdrawal at a professional detox facility where they can receive 24-hour care and supervision.

People who are pregnant should not generally take benzodiazepines, as the fetus can develop a dependence in the womb, and the baby may experience withdrawal symptoms after birth. 

Can Benzodiazepines Cause Permanent Harm?

The majority of the health risks associated with benzodiazepines should go away if a person listens to their doctor’s recommendations and tapers their dosing appropriately. Even if your benzodiazepine use has been unprescribed or otherwise illegal, you should still talk to a medical professional, likely an addiction professional, about the best way to stop taking benzodiazepines.

Most of the most serious risks associated with benzodiazepines are those that might result in a serious injury that wouldn’t have occurred if you weren’t taking the medication. Incidents like motor vehicle and heavy machinery accidents, as well as hip fractures, have the potential to cause long-lasting, potentially life-threatening, damage if they do occur.

Benzodiazepine addiction also has the potential to significantly impact a person’s quality of life and overall health, especially if it results in damaging their relationships and causing financial difficulties. Benzodiazepines are also frequently misused with other drugs, such as opioids, which can significantly increase a person’s risk of a life-threatening overdose.