Benzodiazepines

You need to take extra care when taking benzodiazepines because they can cause sleepiness and affect your concentration.

Avoid or limit alcohol

• Avoid alcohol while you are taking benzodiazepines, especially when you first start treatment.
• Drinking alcohol while taking benzodiazepines causes severe drowsiness and impaired concentration and increases your risk of falls.
• If you do drink alcohol, drink only small amounts and see how you feel.
• Do not stop taking your medicine.

Be careful when taking other medicines that affect your concentration

• Taking some other medicines (eg, antihistamines, antidepressants or pain relief medicines) or herbal products together with benzodiazepines may make sleepiness and impaired concentration worse. 
• Check with your pharmacist if you are taking other medicines or herbal products.

Take care when driving or operating machinery

• Benzodiazepines are likely to affect your concentration and ability to drive.
• Don't drive until you know how the medicine affects you, especially when you first start treatment.
• The effects of most benzodiazepines can last into the following day.
• Read more about driving and medicines.

You are at increased risk of falls

• In addition to affecting concentration and causing next-day sleepiness, benzodiazepines can also cause muscle weakness.
• All these effects put you at increased risk of falls, especially if you an older adult.
• Read about preventing falls.

Long-term use of benzodiazepines for sleep problems and anxiety is not recommended. When they're used for sleep problems and anxiety, benzodiazepines are best used for a very short period, or occasionally as a one-off dose. Ongoing use isn't recommended as your body gets used to the medicine quickly and it becomes less effective. After a few weeks it's likely that benzodiazepines will have little effect and you may also become dependent on it. You may feel that you can't cope with your day-to-day life unless you take them.

What are the benefits of reducing or stopping benzodiazepines?

The benefits of gradually reducing or stopping benzodiazepines include:

• feeling more alert and in a better mood
• feeling able to do more activities, including socialising or work
• reducing your risk of drowsiness and risk of falls
• being able to drive safely (it's against the law to drive while impaired)
• having fewer side effects.

How can I lower my benzodiazepine dose safely?

Make a plan with your healthcare provider to lower your benzodiazepine dose

If you have been taking benzodiazepines for a long time, it's important that you make a plan with your healthcare provider to lower your dose gradually, rather than suddenly stopping taking them. This is called tapering. Suddenly stopping benzodiazepine can cause severe withdrawal symptoms.

What are withdrawal symptoms?

Withdrawal symptoms are changes in how your body and mind feel when you suddenly stop taking benzodiazepines. They may develop within 1 day or up to 3 weeks after stopping, depending on which medicine you are taking. Examples of withdrawal symptoms include sleep problems (insomnia), anxiety, loss of appetite, weight loss, tremor, increased sweating and ringing in your ears (tinnitus) and hallucinations. Some symptoms may be very similar to the condition the medication was being used to treat, which can lead to increased use. Some symptoms may continue for weeks or months after stopping benzodiazepines. In severe cases, stopping benzodiazepine or zopiclone suddenly can cause seizures, delirium, or psychosis – these can be life-threatening.

What is tapering?

Tapering is the gradual lowering of your dose or stopping your medicine in a planned way. This reduces the chances of withdrawal symptoms. Tapering includes the following steps:

• It takes time to stop a benzodiazepine: Your benzodiazepine medicine will need to be reduced slowly. The time it takes depends on the medicine, your dose and how you are coping.
• Have regular reviews with your healthcare provider to discuss how tapering is going: See your healthcare provider regularly to monitor your progress and talk about any issues you may be having.
• Build a support network: Lowering your benzodiazepine dose can be difficult. Prepare your support group, including your whānau, friends and healthcare team.
• Manage withdrawal symptoms if they happen: Some people have withdrawal symptoms, which may include flu-like symptoms, nausea, diarrhoea and stomach aches. These are temporary and usually not dangerous. Your healthcare provider may recommend reducing your dose more slowly if you get withdrawal symptoms that are difficult to manage.
• Use other strategies to manage your sleep and anxiety: You will need to use other strategies to manage them before, during and after lowering your benzodiazepine dose. Strategies may include being more active during the day, stretching, relaxation or breathing techniques.