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PTSD: National Center for PTSD

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Benzodiazepines and PTSD

 

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This section is for Veterans, General Public, Family, & Friends

This section is for Veterans, General Public, Family, and Friends

Benzodiazepines and PTSD

Benzodiazepines are medications given by a doctor to improve anxiety and sleep. They do not help with PTSD symptoms and can have serious side effects over time. There are better treatment options.

What are benzodiazepines?

Benzodiazepines, also known as "benzos", are a group of medications that make people feel calm, relaxed, or sleepy. They are recommended for short-term treatment of severe anxiety, panic, or insomnia. They are also used to treat or prevent seizures.

Some commonly used benzodiazepines are: alprazolam (Xanax®), clonazepam (Klonopin®), diazepam (Valium®), lorazepam (Ativan®), and temazepam (Restoril®).

What problems arise from long-term use of benzodiazepines for PTSD?

Benzodiazepines provide short term relief from distressing feelings but can become a problem in the long run. You can become dependent on the medication and end up feeling like you cannot face stressful situations without it.

"Part of the crutch of benzodiazepines is that you feel like you can't live without them"
Veteran, Leah Parady

If you use benzodiazepines to escape reminders of your trauma, you never truly learn to manage your stress. This makes it harder to recover from PTSD. Effective treatments for PTSD, like talk therapy, help you stop avoiding distressing situations and memories.

Dr. Laura Gibson describes how benzodiazepines get in the way of PTSD treatment.

If you take benzodiazepines for a long period of time you can become physically dependent. This means you would go into "withdrawal" without the medication. In withdrawal, cravings can be constant and intense. At this point it is hard to stop taking the medication. Efforts to obtain the medication to stop the withdrawal symptoms can get in the way of other things like work and family. It can also be dangerous if done suddenly, without the help of a health care provider.

Dr. Ed MacPhee talks about the need, over time, to take more benzodiazepines (tolerance) and the risk of stopping them suddenly (withdrawal).

"Benzodiazepines tend to create a lot more problems than they actually resolve."
Dr. Ed MacPhee, VA Psychiatrist

There are other problems with benzodiazepine use that you should know about:

  • Accidental overdose. Taking benzodiazepines and alcohol, street drugs, strong pain medication (opioids) or other sedatives at the same time can be fatal.
  • Mood problems. Benzodiazepine use can create problems with depression, irritability, and anger.
  • Trouble with thinking and memory. Benzodiazepines can lead to poor attention, confusion, and fogginess. Use of benzodiazepines is linked to dementia and Alzheimer's disease.
  • Slow reaction time. People taking benzodiazepines have more car accidents and falls, which can result in fractures and other injuries.
  • Breathing problems. Benzodiazepines make chronic obstructive pulmonary disease (COPD) and sleep apnea worse.
  • Pregnancy risks. Women who are pregnant or planning to become pregnant should be aware of possible risks of benzodiazepine use on their newborn. These children may be born early, have a low birth weight, or experience symptoms of withdrawal.

Veteran Leah Parady describes the side effects she felt when she was dependent on the benzodiazepine Klonopin®.

How do you decrease benzodiazepine use?

You should not stop benzodiazepines suddenly. It's safer to decrease the amount taken slowly, called tapering. The taper usually takes 4 to 6 months but can take longer in people who have been taking benzodiazepines for a long time. When you are ready to start tapering, talk to your provider.

Veteran Leah Parady offers her advice to people who want to get off benzodiazepines.

"Stick with it. I think that's the most important thing. These changes do not happen overnight."
Dr. Ed MacPhee, VA Psychiatrist

Tapering slowly helps reduce uncomfortable withdrawal symptoms. There are also some medications that can help with the discomfort. Coping skills such as deep breathing, relaxation, mindfulness or exercise can reduce symptoms. Getting help from family and friends or joining a support group can also help.

Dr. Ed MacPhee talks about how important the therapeutic relationship is to successful tapering.

"So, you know, as long as it takes, it doesn't matter. Just go slow, acclimate to each withdrawal level, and then, get off of it, just take your time and do it."
Veteran Leah Parady

What are better options for treating PTSD?

There are many effective treatment options. Trauma-focused therapy and some antidepressants work best. Talk with your provider about which options are best for you.

Veteran Leah Parady talks about the things she does to stay off benzodiazepines.

Dr. Ed MacPhee describes two important alternatives to benzodiazepines.

What is life like after reducing benzodiazepines?

Research shows that many people who slowly stop benzodiazepines can stay off them and feel better. You may notice more alertness, better coordination, and improved memory and mood. Once off of benzodiazepines, you can get a treatment for PTSD that has better, more lasting benefits.

"I'm off the benzodiazepines. It was a really, really rough road. I didn't think I'd make it, but I did it."
Veteran, Leah Parady

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PTSD Information Voice Mail:
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Contact Us: ncptsd@va.gov
Also see: VA Mental Health

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