What to Do for Anxiety? “Benzodiazepines, of course.” Hold on There, Partner!

long term benzo use alzheimers

What to do for anxiety? Well, you just left the doc’s office with a script for Klonopin. So, I guess that’s that. Or is it? Plenty of downside to benzo use, especially long-term. Yep, hold on there, partner.

If you’re pondering how to treat your anxiety, benzodiazepines may seem like an easy – even logical – choice. However…

Having used clonazepam (Klonopin) on a daily basis for two years many moons ago, I have no doubt our friend’s anxiety will lessen in intensity. The bigger issue is, at what cost?

Oh, s/he may be aware of the potential for tolerance, dependence, and withdrawal from benzodiazepines (benzos). But I wonder about being dialed in on the potential awful consequences of long-term use?

Couple of things before we roll. It’s on me to bring you objective information regarding anything having to do with the mood and anxiety disorders. It’s not on me to tell you what, or what not, to do – or pass judgment.

I’m not a physician but take your benzo issues to yours. A counselor wouldn’t hurt either.

Okay, let’s go…

A Quick Benzodiazepine Review

Two years ago, I posted a three-part series on the benzos. Plenty of important information, so be sure to start with part one and link your way through.

Thing is, though, I didn’t include much about the potential for major issues from long-term use. And I need to make that right.

In review, the benzodiazepines – alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), diazepam (Valium), temazepam (Restoril), and many more – act upon our most abundant inhibitory neurotransmitter, gamma-aminobutyric acid (GABA).

Depending on the benzo, the action can be sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, muscle relaxant, and amnesic-dissociative.

Long-Term Benzodiazepine Use

I think most folks are aware of the potential for tolerance, dependence, and withdrawal when it comes to benzo use. The possible hazards of long-term use? I’m not so sure.

By the way, there isn’t a solid definition of “long-term use.” It frustratingly varies from researcher to researcher, doc to doc, case to case.

Effects of Long-Term Benzodiazepine Use

how long should i stay on benzos

“Hmm, I had no idea. I really need to think this over.”

As I list effects of long-term benzo use, understand they don’t present in 100% of cases. Still, it’s important to know what you may be facing should you have an extended relationship with benzos.

You’ll see I’ve included cognitive issues. Now, there’s been a lot of talk about long-term benzo use causing Alzheimer’s disease and other dementias. We’ll honor the potential, but keep in mind that as research progresses, what was believed to be true may be disproved.

Okay, let’s take a look..

  • General cognitive impairment
  • Impaired concentration and memory
  • Personality changes
  • Perceptual disturbances
  • Disinhibition
  • Aggression
  • Emotional clouding
  • Depression
  • Irritability
  • Derealization/depersonalization
  • Social deterioration
  • Problems at work/school
  • Exacerbation of physical and emotional/mental conditions
  • Sexual dysfunction
  • Paresthesia
  • Nausea
  • Headaches
  • Dizziness
  • Lethargy
  • Sleep problems
  • Immunological disorders

A stunning list, don’t you think? No doubt about it, this can be scary business.

Which brings me to a pet peeve: lack of informed consent. I’m sure there are plenty of prescribers who share information about benzo long-term use, tolerance, dependence, and withdrawal with their patients. And I’m just as sure there are many who don’t. That’s a problem.

That’ll Do It

There’s no way I could include every relevant tidbit of information about long-term benzodiazepine use. So, if you want to be fully informed, chat with your doc and counselor. Online research will help as well.

If you’re pondering how to treat your anxiety, benzodiazepines may seem like an easy – even logical – choice. However, beyond tolerance, dependence, and withdrawal is the potential for serious harm from long-term use.

Yep, hold on there, partner.

The Chipur benzodiazepines articles…

Benzodiazepines: The Need-to-Know Series

Benzodiazepines: The Need-to-Know Series | Dependence

Benzodiazepines: The Need-to-Know Series | Withdrawal

What to Do for Anxiety? “Benzodiazepines, of course.” Hold on There, Partner!

Benzodiazepines: The Gifts That Keep on Giving

Benzodiazepines: Time to Say Goodbye?

Would you like to read yet more Chipur articles? All you have to do is take a peek at the titles.

  • Patricia Miller June 24, 2013, 9:17 pm

    Okay, so now I’m anxious about my antianxiety medication and I already spend at least 45 minutes trying to decide if this one is “bad enough” to warrant medication. ARGH. I try other strategies first to take it down a notch. Yes, I read up. Sigh. Thank you for the information and now I’m one scared consumer.

    • chipur June 24, 2013, 10:54 pm

      Well, I didn’t intend to frighten/uptighten my readers. However, this is information that just had to be posted. Okay, not all will fall prey to the nasty consequences of long-term benzo use; however, I would have been remiss for not pointing-out the possibilities. I very much like your approach to your PRN (as needed) use of the benzo you use, Patricia. As always, thank you for your participation/contribution…

      • Patricia Miller June 25, 2013, 10:41 am

        It is always good to be informed, and that is one of the things I count on you for Bill. Chipur has current, accurate information about important mental health issues and trends. A healthy dose of fear with the use of psychotropic medications is probably not a bad thing, particularly when paired with knowledge. Too many times I’ve approached my medical prescriber with information he or she has NOT been aware/informed about and thankfully neither have been offended or hesitant to follow up. I recognize that I am fortunate to have a medical team that treat me as an equal partner in the conversation, and that is nice, particularly since it would be my body at risk.

        Once again, thank you for bringing timely and crucial information to us. Your research helps me become more informed, and your kind words of comfort truly make a difference with my fear/trepidation/over-responsiveness.

      • chipur June 26, 2013, 9:04 am

        You’re welcome, Dahling! Bill

  • Mike July 16, 2013, 11:52 pm

    So…you can be haunted by the night…manage your anxiety during the day and the body gets back at you when you close your eyes. What is the secrete to getting a good nights sleep? Lots of vigorous exercise. Avoid all stress factors if at all possible. Stick to drinking water or meditation tea’s after 5 PM ( no caffeine or other natural stimulants ) and a healthy does of melatonin 1 hr before bed. Steam room or sauna get a good sweat as this also exhausts the body and causes the release of endorphins similar to exercise. Meditation music, very cool room with ice packs by the bed ( night sweats from Anxiety ). When ALL of this fails…just be prepared to be tired the next day…? Or…how about a decongestant like Benadryl? ALL of these are better than a Benzo before bed…eh?

    • chipur July 17, 2013, 10:30 am

      I’m likin’ it, Mike. Excellent advice. And now to share on Chipur Facebook Fan Page. People need to read this. Thank you…

    • Jody Lamb July 20, 2013, 9:22 pm

      Great advice! It always floors me when I see people drink tea, coffee and pop (soda for non Midwesterners!) late in the afternoon when I’ve often heard them complain about having trouble sleeping most nights.

      • chipur July 21, 2013, 10:17 am

        Doesn’t make a whole lot of sense, does it, Jody? It’s either one or the other – do something about that which ails you or stop complaining! Right???

  • Cathy | Treatment Talk July 19, 2013, 12:08 am

    Great information here for anyone suffering from anxiety. It would seem logical to try natural cures first if at all possible, rather than jump to medication. I appreciate your warning about the dangers.

  • herbybell July 19, 2013, 12:43 am

    As my pulse quickened with your opening teaser, I am now taking deep, tearful breaths of joy as I read your no-nonsense, real-deal and informative clarity on this great American pastime.

    The tears come from the loss of family members to these powerful chemical agents while also feeling grateful there are professionals like you who are bringing more of us up to speed as informed, health conscious people.

    Move well, eat well and think well and life’s inevitable, occasional anxiety becomes something to observe rather than medicate.

    Thank you, Bill. A great resource.

    • chipur July 19, 2013, 10:04 am

      Well, thank YOU for visiting and contributing, herbybell. Heart goes out to you for your losses. All so preventable, don’t you think? Granted, we can’t help them; however, we can sure lend a hand to others as they consider remedies for that which ails them. Chipur readers, please take to heart herbybell’s content. This is a very real and dangerous matter.

  • Lisa Frederiksen July 19, 2013, 10:16 am

    Wow! You’ve packed so much important information here, Bill! As one who was prescribed medication for “situational depression” years, ago, I can attest to your list of long-term side side effects – even though I stopped taking them within a relatively short period of time. Perhaps one of your upcoming posts will be on alternatives to benzodiazepines to treat anxiety?? Thank you for this one – will definitely be sharing!

    • chipur July 19, 2013, 4:42 pm

      Well, one always get their max bang for the buck (actually, it’s free) here on Chipur. Thanks for the suggestion, Lisa, on the alternatives to benzodiazepines piece. I’ll roll up my sleeves…

  • Jody Lamb July 20, 2013, 9:23 pm

    Wow – thanks for the heads up! I’ll spread this important warning.

    • chipur July 21, 2013, 10:17 am

      You’re welcome, ma’am!!!

  • Inspired August 30, 2013, 8:40 pm

    I was prescribed Klonopin for post-traumatic stress disorder following a physical attack, many years ago. I suffered horrible insomnia and nightmares when I did finally get to sleep. The Klonopin dose was low, and just one at bedtime. Two years later, when I moved from one coast to the other, it became impossible for me to renew my presciption, even through a psychiatrist! So I just thought “Oh well, no big deal.” I have never been so wrong. It was a huge deal. I went through 30-plus days of withdrawal that were Hell on earth. I could not sleep, was irritable and irrational, super over-emotional, it was terrible. I have never taken that drug again, but then had a terrible experience, over 20 years later, with Ativan. I was given it in the hospital to ease an asthma attack, and found that it also did a remarkable job at taking the edge off of my muscle spasms. A month in, I ran out, thought nothing of it, and the rebound anxiety was absolutely terrifying. I was titrated down on the dose, and switched to Robaxin for muscle spasms, with an occasional Valium when the going gets rough. For some reason I do not have the same response to Valium that I do to other benzo-type drugs. Buspar worked well for me for anxiety, just a little bit of it when I needed it, not all the time, which is sort of weird from a clinical perspective. I think it comes down to learning to control your anxiety with the help of someone like Bill, and sparingly using drugs if critical, but get to the point where you don’t need them! For me, anything that was in Michael Jackson’s medicine cabinet does not belong in mine.

    • chipur August 31, 2013, 9:34 pm

      Thanks for sharing your story, Inspired. Lots of personal insight gained, it seems. I’m with you – when it comes to managing anxiety turn to therapy/counseling first. Yes, if circumstances warrant, consider meds – however, do so believing they aren’t a permanent proposition…

  • Gilda Sanchez September 1, 2013, 1:07 pm

    A recent study seems to point out that GABA inhibition (braking) influences Serotonin activity. Perhaps augmenting with an SSRI along with a short-term GABA inhibition medicines may help? Still, psychotherapy is still very crucial in helping one to overcome what triggers their anxiety. See this for the recent study: http://www.sciencedaily.com/releases/2013/08/130829214302.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain%2Fneuroscience+%28ScienceDaily%3A+Mind+%26+Brain+News+–+Neuroscience%29&utm_content=My+Yahoo

    • chipur September 1, 2013, 6:26 pm

      Thank you, Gilda. Chipur readers, this article is well worth reading. It’s very interesting and fosters hope. Yes, science seems to be working on reasonable (I hope) remedies for that which ails us. Keep coming back, Gilda. Your contributions are appreciated…

  • BC315 November 28, 2013, 6:18 am

    If you were in fact, taking benzodiazepines for the treatment of anxiety disorders, then how is it possible to remain objective concerning the topic? I’m pretty sure once an opinion is formed it is biased and no longer objective data. If you think Benzo’s are difficult concerning rebound effects, try Lithium. Not too many articles warning about lithium dependence but if facing severe penalties if stopped immediately then I guess it’s just as dangerous if not worse. See, that’s my opinion, and its biased.

    • chipur November 28, 2013, 2:37 pm

      Oh, I don’t know, BC315 – I’m thinkin’ I’m a pretty objective hombre. Sure, I believe long-term benzo use can equate to trouble for many, yet I have numerous clients who use them and they’ll attest to the fact it’s typically a topic of discussion only when they bring it up. I readily acknowledge the potential pitfalls of lithium cessation. In fact, Chipur readers, here’s a link to an informative article on lithium from “Coming Off Psychiatric Medication.” http://www.comingoff.com/index.php?option=com_content&task=view&id=27&Itemid=47 Really glad you stopped-by, and I appreciate your contribution…