8 Benzodiazepine Side Effects You Should Know About
Key takeaways:
Benzodiazepines help treat many health conditions, including seizures, anxiety, and panic disorder. But they have some common side effects, such as drowsiness and dizziness.
More serious benzodiazepine side effects include falls, misuse, and overdose. These risks are increased if you take more benzodiazepines than what’s prescribed.
To avoid serious risks, try to minimize benzodiazepine use. Take the lowest dose possible for the shortest amount of time. And avoid taking benzodiazepines with opioids or alcohol.
Table of contents
Benzodiazepines are a group of medications that treat anxiety, panic disorder, and seizures. Some benzodiazepines can also help people with trouble sleeping (insomnia). They’re also used off-label to treat certain conditions, such as alcohol withdrawal syndrome.
But even though these are commonly prescribed medications, they have significant risks. Here, we’ll cover eight benzodiazepine side effects to know about and how to manage them.
1. Drowsiness
Many people feel drowsy after taking benzodiazepines. For example, studies of alprazolam (Xanax) and lorazepam (Ativan) show that drowsiness is one of the most common side effects.
Some people may be able to use that drowsiness to their advantage. For example, temazepam (Restoril) is FDA-approved to treat short-term insomnia. And your healthcare provider may recommend taking a benzodiazepine at night to help treat insomnia due to anxiety.
But if you take benzodiazepines during the day for any reason, you’ll need to pay close attention to how drowsy they make you. This is especially true if you take other medications that cause drowsiness. These include:
Opioids, such as oxycodone (Roxicodone, Oxycontin)
Sleep medications, including zolpidem (Ambien)
Muscle relaxants, such as cyclobenzaprine
Some over-the-counter (OTC) antihistamines, including diphenhydramine (Benadryl)
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Taking benzodiazepines with any of these medications increases your risk of feeling too tired to complete your daily tasks safely.
Talk with your healthcare provider if you have excessive drowsiness with benzodiazepines. They may recommend decreasing your dose or trying another medication.
Keep in mind: It’s best to avoid activities that require mental alertness when you start taking a benzodiazepine (or if your dose is increased). This gives you time to see how your medication affects you. Activities that require alertness include driving and operating heavy machinery. Once you know how benzodiazepine affects you, you’ll be able to tell which activities you can do safely.
2. Dizziness
Dizziness is another common benzodiazepine side effect. You may also feel weak or “woozy.” Just as with drowsiness, dizziness can make it difficult to complete your daily activities. This is another reason to avoid activities such as driving and operating heavy machinery when first starting a benzodiazepine. Pay attention to whether your benzodiazepine causes dizziness before resuming these activities.
If you’re feeling dizzy, try sitting or lying down until the symptoms go away. But if the feeling lasts several days and is impacting your daily life, let your healthcare provider know. They can help you decide if you need to lower your dose or try another medication.
Good to know: If you take benzodiazepines with other medications that cause dizziness, this side effect can worsen. For example, blood pressure medications and antidepressants can both cause dizziness. Before starting a benzodiazepine, give your provider and pharmacist a list of all medications you take, including OTC medications as well as supplements. They can take a look and see if any of your other medications cause dizziness.
3. Falls
Dizziness and drowsiness from benzodiazepines can lead to trouble with coordination. This can increase your risk of falling, especially if you’re over 65. Falls can be more dangerous for older people as they’re more likely to lead to fractures, which increases the likelihood of needing to go to the hospital. In fact, benzodiazepines aren’t generally recommended in people over 65.
If you’re taking a benzodiazepine, let your healthcare provider know if you’re having trouble with your balance. They can help determine whether you’re at higher risk for falls.
4. Sexual problems
Benzodiazepines may cause sexual problems. These include changes in libido (sexual desire) and trouble having an erection (erectile dysfunction) or orgasm. However, sexual side effects from benzodiazepine use haven't been well-studied. So we don’t know how likely it is to experience sexual problems if you take the medication.
Several other medications can also cause sexual problems. And mental health conditions such as anxiety can cause sexual dysfunction, too. This makes it hard to figure out the exact cause of sexual problems. If you notice any bothersome changes after starting a benzodiazepine, let your healthcare provider know. They can help you figure out the cause.
5. Memory problems
Benzodiazepines may cause short-term memory loss. For example, you may have trouble remembering things or feel more forgetful than usual after taking a dose of benzodiazepine.
Forgetfulness may last for several days if you take a long-acting benzodiazepine, such as diazepam (Valium). It lasts a long time in the body, so blood levels of diazepam may be high for many days after taking it.
If you notice any memory issues while taking a benzodiazepine, let your healthcare provider know. In many cases, the memory issues will improve after you stop taking the benzodiazepine. But don’t stop taking your benzodiazepine or make any changes in your dosage without talking to your provider first.
Good to know: Some research shows that taking benzodiazepines for over 3 months may cause issues with memory and functioning even after you stop taking them. This may include problems paying attention, finishing tasks (executive function), and recalling recent information. But the research isn’t clear on whether benzodiazepines cause more significant long-term memory problems, such as dementia.
6. Dependence and misuse
All benzodiazepines are controlled substances. They can cause physical or mental dependence and misuse. Controlled medications also have limitations around how they’re prescribed and refilled.
Taking benzodiazepines can make you feel like you need them to function normally. This is called dependence. It can happen even if you take benzodiazepines exactly how they’re prescribed. Dependence can sometimes lead to misuse, but not always.
However, taking higher benzodiazepine doses or taking them for longer than intended can lead to misuse. All benzodiazepines come with a strong FDA warning about misuse. Benzodiazepine misuse is also known as sedative use disorder, a type of substance use disorder. It often involves other medications, such as opioids or alcohol. And this can make it more likely to experience an overdose (more on that below).
Taking benzodiazepines exactly as prescribed, and letting your healthcare provider know if you find yourself taking too much, are important to avoid misuse.
If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.
7. Overdose
Taking too much of any benzodiazepine can lead to an overdose. Possible symptoms of benzodiazepine overdose include:
Confusion
Extreme tiredness
Trouble talking
Poor coordination
Severe anxiety
Major mood changes
More seriously, trouble breathing, coma, and death are also possible. The risk is higher if you take other substances or medications that can slow your breathing. These include:
Opioids, such as hydrocodone
Sleep medications, including zolpidem
OTC antihistamines, such as diphenhydramine
Even if you’re not experiencing symptoms right away, a benzodiazepine overdose is serious. If you or a loved one has taken too much of your benzodiazepine, seek emergency medical care immediately by calling 911.
Good to know: Overdoses are more likely if you have a sedative use disorder. If you think a loved one may have a problem with benzodiazepines, check out this GoodRx article for tips on how to talk to them about the problem.
8. Withdrawal
If you’ve been taking benzodiazepine regularly, stopping it abruptly (or lowering your dose too quickly) can cause benzodiazepine withdrawal.
Withdrawal is more likely if you’ve been taking benzodiazepine for a long time. Symptoms of withdrawal may include:
Diarrhea
Sweating
Shakiness
Tremors
Muscle pain
Restlessness
Irritability
Anxiety
Panic attacks
More serious symptoms of withdrawal are rare, but possible. These include delirium (feeling disconnected from reality) and seizures.
To avoid withdrawal, don’t stop taking benzodiazepine abruptly. If you need to lower your dose or stop the medication, your healthcare provider and pharmacist can help you come up with a plan for how to safely do it.
When should you contact your healthcare provider about benzodiazepine side effects?
If you have mild benzodiazepine side effects, such as tiredness or dizziness, they may improve over time. But if they don’t improve, let your healthcare provider know. Dizziness and drowsiness can increase your risk of falls and prevent you from completing your daily responsibilities.
If you experience any signs of benzodiazepine misuse, such as taking extra doses or having cravings for the medication, you may need additional support. Talk to your provider as soon as possible. They can help you navigate treatment options and discuss ways to find additional support.
If you experience benzodiazepine symptoms, stopping the medication abruptly can lead to withdrawal symptoms (especially if you’ve been taking it for a while). So talk to your provider before decreasing or stopping your dose. They can help you come up with a plan to stop it slowly.
The bottom line
Benzodiazepines can help treat many medical conditions, including seizures and anxiety. But they also have significant risks.
Common benzodiazepine side effects include drowsiness and dizziness. More seriously, benzodiazepine use can lead to falls, misuse, and overdose.
To avoid serious benzodiazepine side effects, take your medication exactly as prescribed. Use the smallest amount possible for the shortest amount of time, and don’t take more than your healthcare provider recommends.
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References
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