Are Benzodiazepines a Treatment for Anxiety?

Are benzodiazepines a quick fix or a long-term problem? They are frequently used as a treatment for anxiety but there are potential side effects of benzodiazepines and, even worse, a risk of dangerous benzodiazepine withdrawal.  Learn more about when it may be reasonable to use a benzodiazepine for anxiety treatment and what the risks are.

What benzodiazepines are used for anxiety treatment?

There are several different medications in the benzodiazepine family of medicine. Some common ones are Xanax/alprazolam, Klonopin/clonazepam, Ativan/lorazepam, and Valium/diazepam. Any of one of these can be used as a treatment for anxiety.

These medicines differ in how long they take to have an effect and how long the effect lasts in your body. Xanax is short acting. It works quickly going in and out of your system so it can be helpful for a panic attack. Klonopin, on the other hand, is longer lasting so can be more useful for people that have ongoing anxiety.

Here is a chart showing the relative strength of each benzodiazepine:

Benzodiazepines as Treatments for Anxiety

First the good news: Benzodiazepines can help as a treatment for anxiety

They can help! For anxiety, benzodiazepines can be helpful for short-term and as-needed relief of symptoms. Benzodiazepines work quickly and can ease anxiety symptoms temporarily. For people with a specific phobia (like fear of flying) they can be useful as an adjunct to skills learned in cognitive-behavioral therapy (although ideally, you won’t need medication once you learn skills!).

Benzodiazepines can also be helpful while waiting for an antidepressant to kick in. Antidepressants generally start to work 3-5 weeks from when you are at a therapeutic dose. This can feel like a lifetime for someone who is suffering from anxiety. In addition, some antidepressants can have an initial side effect of making people feel jittery. This is not pleasant for anyone but especially if you are already anxious! Benzodiazepines can be helpful for this temporary side effect.

Now the bad news: There are potential side effects of benzodiazepines and dangerous withdrawal

YES, YOU CAN DIE FROM BENZODIAZEPINES!

Some people wonder why I want to take them off their benzodiazepine when they feel it is helping. Unfortunately, benzodiazepines aren’t good as a long-term cure for anxiety. They can produce dependency and a growing tolerance to the effects of the medicine (where larger doses are needed to get the same effect).

Here is great blog post on the history of benzodiazepines and concerns about their long-term effects: http://www.huffingtonpost.com/van-winkles/is-it-bedtime-for-benzos_b_7663456.html

Benzodiazepine withdrawal:

With regular use, benzodiazepines need to be tapered. Dangerous withdrawal symptoms can happen if they are stopped abruptly (similar to what happens when people go into alcohol withdrawal). Many other unpleasant withdrawal symptoms including insomnia and rebound anxiety can happen once dependent.

In addition to physical dependence, there is always a concern for psychological dependence and addiction. Here is additional information on benzodiazepine withdrawal:https://www.ncbi.nlm.nih.gov/pubmed/7841856

This infographic made by Addiction Blog demonstrates what day-to-day withdrawal from Ativan can be like:

Treatment for anxiety:

There are many different approaches to treating anxiety and some of the most effective treatments aren’t medicine (cognitive-behavioral therapy is one). Benzodiazepines can be a helpful short-term management of anxiety in the right person but are not generally a great long-term solution. They work well as a band-aid but not as a cure!

I have written several posts that talk about ways to overcome anxiety:

Do what you are afraid of! Stop letting anxiety control you

5 Ways to Stop a Panic Attack

Although this series was geared towards overcoming depression, people with anxiety will also benefit. Exercise is a treatment for depression but also benefits anxiety. These posts will be helpful to get started:

Treating Depression with Exercise

Exercise and Depression: How to get started when you want to stay in bed

3 Tips for Exercise: How to stay motivated when depressed

If you are on a benzodiazepine and want to taper off make sure you do this with the help of a medical professional. The time it takes to get off of benzodiazepines will depend on how high your dose is. Let your doctor help you taper off in a safe way to minimize your withdrawal and come up with a treatment plan for your underlying anxiety.

I recommend the following books to learn more about anxiety and how to take control of it. There are additional resources (like great apps!) to target anxiety listed on my resources page and in my bookstore.

This post contains affiliate links to Amazon. Dr. Melissa Welby is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com. Amazon offers a small commission on products sold through their affiliate links. The prices you pay through these links are the same as you would pay going to Amazon directly. Your purchases via the Amazon affiliation links help support the upkeep and maintenance of this blog.

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