Overview

Anti-anxiety medications help reduce the symptoms of anxiety, such as panic attacks or extreme fear and worry. The most common anti-anxiety medications are called benzodiazepines.

Benzodiazepines are a group of medications that can help reduce anxiety and make it easier to sleep. They are also used as a muscle relaxant, to induce sedation for surgery and other medical procedures, and in the treatment of seizures and alcohol withdrawal. Benzodiazepines are also called minor tranquillizers, sedatives or hypnotics. They are the most widely prescribed psychoactive drugs in the world.

The calming effects of benzodiazepines can often be achieved without drugs.

Various kinds of exercise, such as walking, running, yoga or tai chi can help, as can reducing the stress in your life and taking time for relaxing activities such as meditation, reading a book or having a warm bath. Talking with a trusted friend, family member or therapist and working out the problems that are troubling you can also help. Whenever possible, these approaches should be tried first, before benzodiazepines. However, when non-drug approaches are not possible or do not help, benzodiazepines can provide relief.

When used appropriately, benzodiazepines are safe and effective drugs. They do, however, have potential for abuse and can be addictive. For this reason, they are usually only recommended for short-term or occasional use.

Do I need this treatment?

A certain amount of anxiety or insomnia is a normal reaction to what is happening in your life. You may worry or feel stressed, and sometimes these feelings can keep you up at night. Most often, these feelings pass and are not a problem. However, these feelings can become a problem when they continue over a longer term, cause severe distress, make you feel physically ill and affect your behaviour. This kind of anxiety may be triggered by a challenging life event. It can also be a symptom of a mental health problem.

The ability to fall asleep and to sleep through the night can be affected by many types of health problems. These include physical conditions that cause pain or trouble breathing, as well as mental health problems. When sleep is disrupted, health can be further affected.

While each situation is unique and different treatment approaches may be called for, benzodiazepines can help to provide relief.

What does Anti-anxiety Medications (Benzodiazepines) do?

Benzodiazepines enhance the activity of the neurotransmitter GABA—a chemical in the brain that helps you to feel calm. Their effect also produces drowsiness, making it easier to fall asleep and sleep through the night.

Side effects of Anti-anxiety Medications (Benzodiazepines)

The side-effects of benzodiazepines are generally mild and may not be noticed when these drugs are used at low doses.

Common side-effects include:

  • drowsiness
  • sedation
  • dizziness
  • loss of balance.

At higher doses, side-effects can include:

  • confusion
  • disorientation
  • amnesia
  • breathing difficulties
  • depression.

Other possible effects, which are extremely rare, include agitation, hallucinations and nightmares. Reducing the dose can help to reduce side-effects.

Benzodiazepines can make it harder to learn and remember new information and to do certain physical and mental tasks. These abilities return to normal once the effect of the drug wears off.

When used to help you get to sleep, benzodiazepines can have some “hangover” effects, such as morning and daytime drowsiness.

Types of Anti-anxiety Medications (Benzodiazepines)

Many types of benzodiazepines are available in Canada. All benzodiazepines work the same way; however, the intensity and duration of their effects vary.

Benzodiazepines most commonly used to treat anxiety disorders are clonazepam (Rivotril)*, alprazolam (Xanax) and lorazepam (Ativan). Also used are bromazepam (Lectopam), oxazepam (Serax), chlordiazepoxide (once marketed as Librium), clorazepate (Tranxene) and diazepam (Valium).

Benzodiazepines used for the treatment of insomnia include lorazepam (Ativan), nitrazepam (Mogadon), oxazepam (Serax), temazepam (Restoril), triazolam (Halcion) and flurazepam (Dalmane).

Another drug used for insomnia is zopiclone (Imovane). This drug is similar to benzodiazepines and has similar side-effects. Zopiclone may have less abuse potential than some benzodiazepines; however, people can still become addicted to this drug.

Benzodiazepines are available in the form of tablets or capsules, which are taken by mouth. Some are also available as a sublingual tablet, which is dissolved under the tongue, or as a solution for injection.

* Medications are referred to in two ways: by their generic name and by their brand or trade names. Brand names available in Canada appear here in brackets. For example, alprazolam (Xanax) and lorazepam (Ativan).

Frequently Asked Questions

How long should I take benzodiazepines?

For most people, benzodiazepines are helpful only as a temporary measure, to be used only in the following ways:

  • on occasion, to help you sleep or when anxiety can’t be managed with non-drug approaches
  • daily, for up to a few weeks, to help re-establish sleep patterns or to reduce anxiety while waiting for an antidepressant or other treatment to take effect.

Some people may continue to use benzodiazepines for longer, even months or years. Some do so because they continue to find these drugs helpful and have agreed with their prescribing physician that the benefits of continuing to use them outweigh the risks. There are also those who continue to use benzodiazepines over a longer term because the prescribing doctor has not re-examined their continued use. In this instance, ask another doctor to review your prescription.

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