The number of things that can impact a person’s mental well-being is wide-ranging and varies with each person. Where some issues may require long-term psychiatric treatment and medication, other issues can be more immediate and have a shorter-term treatment plan. This is where benzodiazepines — often referred to as benzos — can come into play. Two well-known types of benzos are Valium and Xanax.
“Benzodiazepines are medications that can be used for short-term treatment for anxiety, panic attacks and, sometimes, sleep problems,” Dr. Misty Tu, M.D., medical director and psychiatrist at Seattle Anxiety Specialists, says.
“They can be effective because they have a quick onset. They work best when there’s a specific issue at a specific point in time.” If someone experiences anxiety daily, that’s harder to treat in the short-term and often requires a longer-term medication like an antidepressant, she says.
Because benzodiazepines are controlled substances, your doctor will ensure you aren’t abusing alcohol or other drugs as that can impact the effect of the medication. Using alcohol while taking the medication can cause a “rebound” anxiety effect, Tu says.
But benzodiazepines can also be very effective for those undergoing alcohol withdrawal, Dr. Katharine Liang, M.D., Ph.D., consulting psychiatrist at Seattle Anxiety Specialists, says. However, to do this safely, it should be done at a hospital “because alcohol withdrawal can be a life-threatening condition.”
Benzodiazepines also often won’t be prescribed if you’re suffering from other mental health issues that require medication, such as bipolar disorder or schizophrenia.
What are benzodiazepines?
The reason that benzodiazepines are so effective is that they affect individuals quickly: Patients can feel its onset in less than an hour, or at the most a few hours. But both Liang and Tu advise exercising caution when taking the medication.
“Benzodiazepines have a lot of side effects, which is why most doctors have hesitancy in prescribing them, especially on a regular basis,” Liang says.
There are also other concerns, she says.
“They can cause respiratory depression, so using them with other medications that have similar risks, like opiates, can be dangerous and lead to breathing problems or even death. Benzodiazepines can also cause delirium in patients who have other risk factors for delirium, such as dementia.”
What else you need to know:
- Benzodiazepines act as a sedative.
- There are two types of benzodiazepines, hypnotics and anxiolytics. Hypnotics are commonly used to treat sleep problems like insomnia; anxiolytics are often used as an anti-anxiety medication.
- There are side effects — drowsiness, dizziness, confusion, flattened emotional state and muscle weakness are a few. Speaking, balance, vision and motor skills can also be impacted.
- Benzodiazepines should not be taken for longer than one month.
- If you stop taking benzodiazepines, you may experience withdrawal symptoms.
Are benzodiazepines safe?
There are so many different types of benzodiazepines that you need to work with your doctor to ensure you receive the right prescription.
“Like any medication, there are lots of considerations when deciding which medication to prescribe,” Liang says. “One of the big considerations is how long the medication is active. In general, medications that stay in your system the longest also take a little longer to have an effect.”
“Different benzodiazepines are used for different issues,” Tu says. “There are medications that are longer acting and ones that are shorter acting. It’s important to work with your doctor to understand what symptoms you want addressed.”
Since different benzodiazepines are used for specific, short-term purposes and quickly provide relief, they can be very effective Liang and Tu say, but over time they will lose their effectiveness. “Taking them long term will result in needing more and more to achieve the same effect,” Liang says.
If you’re prescribed benzodiazepines, it’s important to know that it’s a short-term treatment that must be done in tandem with your doctor.
“All benzodiazepines carry some risk of physiological addiction, especially when used chronically over a period of about one month,” Tu says. “The dosage and frequency of the medication are some of the largest factors of addiction risk. When the medication is used more sporadically, there’s less risk of addiction.”
“The most addictive benzodiazepines are fast on, fast off,” Liang adds. “Most doctors will require regular follow-up appointments, because in most cases the goal would be to come up with a plan for a short-term prescription, not to continue taking benzodiazepines indefinitely.”
If you feel you’ve become addicted to the medication, your doctor can help you slowly and safely decrease the amount of medication you’re taking.
Liang concludes, “Benzodiazepines come with a fair degree of risk, but they do serve an important purpose in certain clinical situations. Most psychiatrists are extremely experienced and comfortable dealing with benzodiazepines and know how to prescribe them safely. We’re often the ones other doctors turn to when they have complex cases involving benzodiazepines.”
Seattle Anxiety Specialists, PLLC is a private psychiatry and psychotherapy practice in downtown Seattle, providing evidence-based treatments and in-depth self-exploration for anxiety and conditions that create anxiety including phobias, depression, GAD, OCD, PTSD, ADHD, OCPD and bipolar.