2
Key Points
Background
Î Benzodiazepines (BZDs) are approved by the US Food and Drug
Administration (FDA) to treat a wide range of conditions, including
anxiety and panic disorders, social phobia, insomnia, and seizures and
are commonly prescribed.
Î Use of these medications is associated with increased risk for adverse
events, including falls, motor vehicle accidents, cognitive impairment,
delirium, overdose, and death, particularly when BZDs are used in
combination with central nervous system (CNS) depressants such as
alcohol or opioids.
Î When BZDs are used regularly, abrupt discontinuation (i.e., stopping
the medication without a taper) or precipitous dose decreases can
lead to serious and potentially life-threatening withdrawal symptoms
(See Table 3).
Î Physical dependence is a biological phenomenon that develops in
response to repeated use of a medication and is distinct from BZD use
disorder. Nearly all patients who regularly use BZD for more than a
month will develop physical dependence. Only 1.5% of people who use
BZD meet criteria for BZD use disorder.
Î While there are some limited indications for longer term BZD use
(e.g., severe treatment-resistant generalized anxiety disorder (GAD)
or bipolar spectrum disorders, complex seizure disorders, spasticity,
sleep disorders involving abnormal movements), it is generally
recommended to limit BZD use to 2-4 weeks.