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What are Benzodiazepine (Benzos)

Benzodiazepine is a family of psychoactive drugs. They operate on the nervous system causing a change in mood, cognition, behavior, or perception. While benzodiazepines may work as a treatment for anxiety, sleep and agitation in some patients, long-term use can result in a worsening of the very symptoms the medications are meant to treat.

Medically reviewed byDr. Sarah Boss, MD
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Quick Summary

  • Benzodiazepines are sedative medications prescribed for conditions such as anxiety, insomnia, and seizures, but misuse can lead to dependence and serious adverse effects.
  • Possible effects range from drowsiness, confusion, poor coordination, and memory problems to paradoxical agitation, aggression, hallucinations, or changes in personality.
  • High doses, mixing benzodiazepines with alcohol or other drugs, and withdrawal may trigger psychosis; urgent professional help is advised when symptoms occur.

Benzodiazepines, commonly known as benzos, refer to highly potent and addictive drugs that carry sedative properties. Known to manage different conditions like seizures, insomnia, and anxiety, these medications reduce the nerve activity within the brain and the spinal cord to trigger feelings of relaxation. Despite experts repeatedly advising using these drugs as prescribed, an increasing number of people continue to abuse them for the high they produce, especially when taken in high doses. What these people do not know are the countless benzodiazepine dangers they are exposing themselves to by continuing to take these drugs without any purpose or restrictions.

The dangers associated with benzodiazepines can be of different types. Some occur more acutely as soon as someone starts consuming these medications, while others take some time to show up. Nevertheless, each of these side effects can be dangerous to the body and negatively affect one or more aspects.

At present, there are many known side effects of the benzodiazepine. However, because every person is different in anatomy and physiology, they may react to these drugs differently and experience other side effects.

Short-Term Side Effects

Some of the most common benzodiazepine dangers include:

  • Drowsiness
  • Confusion
  • Light-headedness
  • Unsteadiness
  • Dry mouth
  • Slurred speech
  • Dizziness
  • Muscle weakness
  • Blurred vision
  • Constipation
  • Memory problems
  • Nausea

Apart from the side effects mentioned below, some less-common dangers associated with benzodiazepines include:

  • Headaches
  • Increased production of saliva
  • Low blood pressure
  • Rashes
  • Difficulty urinating
  • Digestive disturbances
  • Problems with eyesight
  • Changes in sexual desire
  • Tremors
  • Incontinence or loss of bladder control

Very rarely, benzodiazepines may put users at risk of the following dangers:

  • Blood disorders
  • Jaundice or yellowing of the skin
  • Gynecomastia (the development of breasts in people assigned male at birth)

Long-Term Side Effects

Mentioned below are some benzo long-term side effects:

  • Difficulty concentrating
  • Loss of confidence
  • Feeling isolated and unreal
  • Feeling irritable and impatient
  • Feeling dulled and slow
  • Memory problems
  • Feeling cut off from your emotions
  • Weight problems

Paradoxical Side Effects

In some cases, the use of benzodiazepines triggers specific effects that are opposite of what this medication is meant to do. Referred to as paradoxical effects, these include:

  • Aggressive behavior
  • Anxiety
  • Agitation
  • Irritability
  • Delusions
  • Hallucinations
  • Depression
  • Depersonalization
  • Derealization
  • Nightmares
  • Restlessness
  • Rages
  • Psychosis
  • Changes in personality
  • Suicidal tendencies

These effects can happen regardless of the type of benzodiazepine you are consuming. However, these paradoxical dangers of benzodiazepines are more common in their short-acting alternatives, and older people and children are more likely to experience them than young adults.

Recent research published in a peer-reviewed journal has found an association between the use of benzodiazepine and the development of Alzheimer’s disease, a type of dementia that involves short-term memory loss. Experts now believe that taking this medication for more than six months can increase the user’s risk of dementia. This increase is up to 84 percent in people using this drug than people who do not take benzodiazepines. Moreover, long-acting benzos, for example, Valium, are more likely to trigger these changes in the elderly than short-acting ones, such as Xanax or Ativan. It is also feared that these memory-related changes may not be entirely reversible, and the risk for these damages seems to increase as the user ages.

Despite this significant risk, healthcare practitioners all across the United States continue to prescribe benzodiazepines to the elderly population. The number of elderly people taking this medication group is much higher than the younger population, which is persistently increasing with each passing day. A lot of these elderly users have been using benzos for a long time which further increases the potential adverse side effects and dangers. 

As individuals age, their metabolism continues to slow down. Because the body inside the fat cells stores benzodiazepines, these drugs remain active in older people’s bodies for much longer than in someone young. As a result, this prolonged storage increases the effects of these medications while raising the risk of adverse reactions due to the dosage being higher than what it is meant to be. Benzodiazepines can also impair driving abilities, increase the risk of falls, and interfere with cognition in the elderly. As a result, it is important for this particular age group to use these medications with much caution.

While each drug has its specific mechanism of action, most substances carrying a potential for abuse and addiction can significantly change brain functions in ways that disturb cognition and perception. Benzodiazepines continue to be among these drugs that disrupt the user’s cognitive abilities, changing their mental state, distorting their normal thought processes, slowing their response time, and even negatively affecting their memory. Because of this potential, this category of medication has been commonly associated with benzo psychosis, a much-feared side effect.

Benzo-induced psychosis occurs when an individual consumes a larger dose of benzodiazepine than what has been prescribed to them. This danger can also prevail if someone mixes their regular dose of this medication with alcohol or combines it with other drugs to increase its effects. As a result, intoxication occurs, which tends to alter their perception of reality. This particular danger of benzodiazepine is more prevalent in people who have developed an addiction to this drug and are going through a withdrawal phase.

Benzodiazepines typically enhance the effects of a neurotransmitter called gamma-aminobutyric acid or GABA. GABA is termed an inhibitory neurotransmitter as it works by blocking the messages between nerve cells in an attempt to reduce the activity within the central nervous system. Consequently, an individual who uses benzodiazepine experiences a sense of calm and relaxation. However, in people who use it in large amounts or mix it with other drugs or alcohol, benzos affect the brain so strongly that their judgment gets impaired, their thinking slows down, and they are unable to understand what’s happening to them. As soon as intoxication kicks in, the initial delirium quickly progresses into a full-fledged psychosis with symptoms like hallucinations, visual distortions, paranoia, and confused thoughts.

The symptoms of a benzo psychosis often differ from those of a typical psychotic disorder, such as schizophrenia. These symptoms primarily include paranoid delusions and visual and auditory hallucinations. Another feature that differentiates benzo psychosis from other psychotic disorders is the fact that the symptoms of the former develop much more quickly than the latter. Some other common symptoms of benzo psychosis include:

  • Hearing, tasting, or seeing things that other people cannot
  • Reduced hygiene
  • Having beliefs that don’t align with your culture or don’t make sense to others
  • Having unusual thoughts or beliefs, no matter what others say or what evidence they present
  • Isolation from family and friends
  • Hearing voices that aren’t real
  • Feeling as if you have superpowers or are on a special mission
  • Difficulty thinking clearly or paying attention
  • Seeing people or things that aren’t real or seeing distorted shapes)
  • Feeling as if outside forces are controlling your feelings and behavior
  • Giving significant meaning to small events or comments

The psychosis triggered by benzodiazepines can be extremely disturbing and terrifying. Most people develop it as they withdraw from this drug and often experience other physical symptoms that make the entire experience more uncomfortable and challenging to manage. If you or someone around you has been experiencing the typical symptoms of a benzodiazepine-induced psychosis, it is vital to seek help immediately. If not controlled, certain symptoms associated with this side effect can even prove harmful and potentially life-threatening not only for the patient but for others around them as well. If you have been addicted to benzodiazepines and are considering quitting them, consider seeking help from a professional treatment center instead of trying it on your own to avoid these dangers and detox and recover in a safe and supportive environment.

Questions

Frequently Asked Questions

Are benzodiazepines dangerous?

Benzodiazepines are generally safe if you use them as prescribed and within the proper doses. However, experts agree that these medications must only be taken for temporary relief, and their long-term use can increase the risk of encountering multiple benzodiazepine dangers.

Which type of benzodiazepine is the most toxic?

As per research, the majority of people undergoing benzodiazepine overdose between 1987 and 2002 were using alprazolam. The same drug is one of the most prescribed benzodiazepines in the United States and appears to be much more toxic than other benzodiazepines, such as diazepam.

Which benzodiazepine is the best for long-term use without any significant dangers?

Due to its high potency along with longer-lasting effects, Clonazepam or Klonopin is regarded as the most potent benzodiazepine to use without risking your health.

Can benzodiazepines mess with my memory?

In some people, using benzodiazepines can cause trouble with memory. These issues make it harder to retain new memories as long as you keep on taking the medication. It is very rare for benzos to force you to forget your older memories.

Is it possible to use benzodiazepines safely?

Yes, you can keep using benzodiazepines safely as long as it is for a legitimate medical reason and under the supervision of a doctor. Keep in mind to always stick to the prescribed dose and do not miss out or increase the dose on your own without discussing it with a doctor. If you have been put on these medications for a long time, be sure to be regular in your follow-ups with the doctor and let them be aware of any side effects or problems you have developed due to the use of these drugs in time to avoid any damages later.

Editorial evidence

Evidence & sources

Selected clinical guidelines, peer-reviewed research, and public-health sources used in this article.

01Cochrane. (2019). Benzodiazepines for insomnia (review). Cochrane Library.
02World Health Organization. (2023). Benzodiazepines (information and guidance). World Health Organization.
03National Institute on Drug Abuse. (2024). Benzodiazepines and opioids. National Institutes of Health.
View all 9 sourcesShow fewer sources
04U.S. Food and Drug Administration. (2020). FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. U.S. Department of Health and Human Services.
05National Institute of Mental Health. (2024). Anxiety disorders. National Institutes of Health.View source
06StatPearls Publishing. (2024). Benzodiazepines. In StatPearls. National Library of Medicine.
07Substance Abuse and Mental Health Services Administration. (2023). Benzodiazepines. SAMHSA.View source
08National Institute for Health and Care Excellence. (2022). Generalised anxiety disorder and panic disorder in adults: Management. NICE.View source
09Billioti de Gage, S., Moride, Y., Ducruet, T., Kurth, T., Verdoux, H., Tournier, M., Pariente, A., & Bu00e9gaud, B. (2015). Benzodiazepine use and risk of Alzheimeru2019s disease: Case-control study. BMJ.
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