What are benzodiazepines and Z-drugs?
Benzodiazepines are a group of medicines we use to treat sleeping problems or anxiety. They include:
- diazepam
- lorazepam
- nitrazepam
- oxazepam
- temazepam
- clonazepam
Z-drugs act in a similar way. They include:
- zolpidem
- zopiclone
These medicines often work well for 2 to 4 weeks. But they can be very addictive. If you use them for longer than this, you may become dependent on them. This means you may feel as if you need the medicine to do your everyday tasks.
What are the risks of using them for a long time?
Longer-term use of these medicines is linked to a higher risk of:
- falling and fractures
- feeling emotionally numb
- dementia and Alzheimer’s disease
- confusion and depression
- addiction and dependence
- road accidents
- death
Why should I think about stopping my benzodiazepine or Z-drug?
You may become dependent on your medicine, or you may be dependent on it already. If you have, it’s not your fault. It’s because your body and brain have got used to the medicine.
If you take these medicines for a long time, they can also make anxiety and sleep problems worse instead of better.
You will also have fewer side effects if you stop taking the medicine. You should be:
- more alert and able to concentrate
- less drowsy
- less irritable
- less depressed
- less likely to have a fall or road accident
How should I stop taking my benzodiazepine or Z-drug?
If you’ve been taking this medicine for a long time, we will ask you to come for a medication review. We will talk to you about taking less of your medicine. We’ll help you to stop taking it slowly and safely.
Stopping a benzodiazepine or Z-drug is not straightforward. But we’re here to support you.
Do not stop taking your medicine suddenly
Talk to us to make sure you reduce your dose slowly. We can make a plan that’s tailored to you.
It’s important to do it gradually to reduce the chances of withdrawal effects. This will also give you a better chance at succeeding in the long term.
Plan when you will start taking less
Pick a good time to do it. It’s best to wait until any very stressful times in your life have passed, or until your stress levels are as low as possible.
Plan how you will start taking less
We’ll give you advice on how to start taking less of your medicine. We’ll also help you think about other ways of dealing with your anxiety or sleep problems.
Most people find that lowering their dose every 1 to 2 works for them. But we’ll check in with you regularly to find the best way for you.
Take care of yourself
There are lots of self-care and self-help resources online. Take a look at some of these if you have problems with your mental wellbeing.
NHS guides
- Mental wellbeing audio guides
- Self-help guides, tools and activities
- Anxiety self-help guide
- Sleeping problems self-help guide
Sleepio
This is a free digital programme for treating insomnia and poor sleep. It uses cognitive behavioural therapy (CBT) techniques to help you sleep better. You do 6 ten-minute sessions over 6 weeks. https://sleepio.com/sleepio/nhs/391#1/1
NHS Talking Therapies
This is a free service. You don’t need to visit a GP first to get help. Refer yourself to Talking Therapies online or call 0330 0534 230.
You should also try to get into good habits with sleep.
- Keep regular sleep hours.
- Try not to use computers, smartphones, and TVs before bed.
- Avoid caffeine (for example coffee, tea and energy drinks) and other stimulants (substances that keep you awake and alert).
- Exercise regularly.
- Avoid daytime naps, or try to keep naps short.
Keep a diary
Keeping a diary lets you keep track of your progress and achievements. This can give you more confidence and encouragement to keep going.
Don’t go back
When you reduce your dose, you may feel more able to deal with everyday tasks. You may feel much better.
But it’s also normal to have a bad patch at some point. If this happens, don’t give up. Do not go back to taking more of your medicine. Stick with your current dose until you feel ready to lower it again.
It’s important to take things at your own pace. Remember that any reduction is an improvement.
Be aware of the possible withdrawal effects
Withdrawal effects are symptoms that can happen if your body has become too used to a medicine. If you reduce your medicine slowly, it’s unlikely that you’ll have any withdrawal effects. But it’s useful to know what they may look like.
They could include:
- upset stomach
- hot flushes
- shivering
- agitation or irritability
- sweating and palpitations (when your heartbeat becomes more noticeable)
- visual disturbances
- loss of appetite
- aches and pains
These symptoms usually go within a few months. If you are having problems, call your doctor or pharmacist for advice.