Throughout recorded history, there have been huge challenges: famines, floods, fires, earthquakes, pandemics and wars. People have been complaining about anxiety and stress for hundreds, if not thousands, of years. These days we hear a lot about how stressed out people are. Political and cultural polarization, economic uncertainty and climate catastrophes have a lot of people on edge. As in past decades, many doctors are prescribing anti-anxiety benzos (benzodiazepines) to take the edge off. How well are they working? What about complications?
An Ultra Short History of Anti-Anxiety Drugs:
Before Librium (chlordiazepoxide) and Valium (diazepam) became huge best sellers during the 1960s and 1970s, doctors prescribed some very powerful drugs to calm jittery nerves and help people fall asleep. During the 17th century, doctors offered women laudanum. That was the official name for tincture of opium.
Chloral Hydrate (aka knockout drops):
Chloral hydrate became popular in the 19th century as a sedative. Doctors often prescribed it to help people calm their nerves and for insomnia.
Sea captains “recruited” crew members by having bar owners add chloral hydrate to drinks. This combination became known as a “Mickey Finn.” These knockout drops quickly rendered potential workers unconscious, so they could be loaded onboard a departing ship. The new crew member would wake up far out at sea with no recourse except to start working.
By the early- to mid-20th century, barbiturates had become the tranquilizers of choice. Phenobarbital (Luminal), secobarbital (Seconal) and pentobarbital (Nembutal) were prescribed in large quantities. Then people started overdosing.
If alcohol was part of the mix, it became a deadly cocktail. Famous people who died with barbiturates in their systems included Marilyn Monroe, Judy Garland and Elvis Presley.
As barbiturates began to get a bad reputation, a new sedative began to top the charts. Meprobamate (Equanil, Miltown) became one of the most prescribed drugs during the mid 1950s. Like so many drugs before it, meprobamate was given out to people with jittery nerves and insomnia.
Anti-Anxiety Benzos (Benzodiazepines):
Librium (chlordiazepoxide) got the FDA’s green light in 1960. It became wildly successful and was quickly followed by Valium (diazepam) in 1963. It wasn’t long before anti-anxiety benzos became the most widely prescribed drugs in the world (Journal of Anxiety Disorders, May, 2011).
That seems like a long time ago, but benzos are still widely used today by people suffering from anxiety, insomnia or panic disorder. At last count, over 50 million prescriptions were dispensed for drugs like alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium) and lorazepam (Ativan).
The Love-Hate Relationship with Anti-Anxiety Benzos:
There is a reason we have titled this article the “Love-Hate Relationship.” Over the years we have received a great many messages about benzodiazepines. Many people love these drugs and believe that they cannot live without them.
Others find them challenging for a number of reasons. Before we share some of these messages, though, we thought we would offer you quick trip in our “Way-Back Time Machine.”
In 1966 the Rolling Stones launched their album Aftermath. On it, there was an iconic song titled “Mother’s Little Helper.” Remember, Valium was launched in 1963. Some experts believe that the yellow pills in the song refer to 5 mg Valium pills (Drugs, Dec. 14, 2014).
Others maintain the drug in the song was about Miltown or Nembutal. Regardless, the idea that there is a pill that could calm us down and help get us through a busy day is still very much with us today.
We think you will find the lyrics of interest:
• “Mother needs something today to calm her down
• And though she’s not really ill, there’s a little yellow pill
• She goes running for the shelter of a mother’s little helper
• And it helps her on her way, gets her through her busy day…”
You can listen to the whole song at this link. We think you will find this short musical interlude worth your time.
Readers Share Their Reaction to Anti-Anxiety Benzos:
Terri has been taking a benzo for decades:
“I am 71 years old and have been on clonazepam for 35 years (0.5mg twice/day). I never deviate from the dosage. I am not willing to put myself through withdrawal and lose my quality of life with all the horrific stories about going off these pills. However, more power to those who want to do it. I hope it works for you.”
Byron shares the sad story of a friend weaned way too quickly:
“My friend was using clonazepam for over 40 years as directed by her physician as a sleep aid and for panic attacks. The amount of the drug prescribed over the years varied but during the pandemic the amount was increased to 2.0 mg because the lower dose was not effective.
“A new mental health physician was aghast this friend was on this medication for years, informing her that was a huge mistake, and the drug is meant for short term treatment. She then proceeded via tele-health to taper her off 40 years of addiction in her home.
“This was nuts! As she tapered her, my friend was having radical emotions of crying, screaming, and moments of pure mental agony. Finally, after months of this behavior, (with the cops being called due to her uncontrollable outbursts of terror), another physician put her back on the medication at a higher dosage. It helped her somewhat, but she never regained her normalcy. Coming off the medicine destroyed her already damaged brain.
“It has been over a year and half since this failed tapering effort. My friend cries all day long now, punctuated with some outbursts. She is convinced that the pharmaceutical industry knew all along how damaging these drugs were and that the doctors have also been complicit in prescribing them. Somebody needs to sue them all like they did the cigarette companies.”
Nurse Kathy says that her benzo is no problem:
“I am 71 yo and have been on 0.5mg every night for 10 years! I have not had adverse effects and a time or two I have had to stop without side effects. So first it’s opioids are bad so everyone had to be taken off even if they were in severe chronic pain. Now they are going to do the same with Benzos?
“Why can’t the doctors just treat each patient as an individual without the government getting involved? There are side effects to every drug! I am a Registered Nurse, so I know a little about medications and side effects. Are you all trying to say that in today’s stressful world people should be made to suffer with panic attacks, anxiety, PTSD and on and on with no help? Come on!”
Nicole wants people to stop blaming patients for developing a dependence upon anti-anxiety benzos.
“Please stop calling this a “habit”! It puts blame on the patients. Please remember, patients are in this predicament because a DOCTOR (or other prescriber) TOLD THEM TO TAKE THIS EVERY DAY. Then, when they are inadvertently made physically dependent (iatrogenesis), people write articles about them saying they ‘can’t kick their habit.’
“How about this instead: Benzodiazepines: A Drug Class Your Doctor Should Warn You Could Cause Horrific and Protracted Withdrawal Syndromes (But They Usually Don’t).”
Kat blames benzodiazepines for her sister’s death:
BIND (benzodiazepine-induced neurological dysfunction) killed my sister! The withdrawal was so severe that when I tried to help her get off of alprazolam she wound up in the ER. The physician yelled at me that I was killing her by trying to get her off the drug. She lost her driver’s license because of the seizures. She couldn’t get off of the drug, and her doctor just kept upping the dosage. She died in her sleep at the age of 45.”
Ronald requires diazepam for his dizziness:
“Try living with Meniere’s vertigo without diazepam. No way! I take 5mg five or six times per month, and I am functional. I am 70 years old and going strong as a part-time musician with a great memory.”
Jo-Anne worries about withdrawal complications:
“As a nurse I was eye witness to the horrible withdrawal symptoms when people stop taking Benzos. If physicians just arbitrarily cut people off cold turkey, most patients spiraled down to a severe mentally unstable condition for many months or years (length of time depending on their age). Many ended up in Psych or rehab wards to recover.
“Why a physician, who has been writing benzo scripts for a person for years, cuts that person off abruptly, rather than tapering or weaning them off over a long period, is beyond me. There are many studies showing that if a person has been on them for years, weaning off and or actually staying on them, risking dementia, would be a preferable quality of life, rather than forcing them through withdrawal and a complete deterioration of their mental and physical health.”
Leah finds that anti-anxiety benzos help her feel normal:
“I’ve been taking clonazepam (Klonopin) daily for almost a decade. I’ve never needed to increase my dose. The drug continues to work well. I also take low-dose propranolol (a beta blocker) daily for anxiety & a heart arrhythmia.
“There is no reason to feel bad if you need medication. Over the years I desperately tried practically everything: from medications to meditation, herbs, yoga, diet, exercise, counseling–you name it. Nothing else ever worked in any substantial way.
“I never wanted to be dependent on a pill, which is why I waited until age 29 to try it. What a shame I was afraid and didn’t try it sooner. So many wasted years and so much unnecessary suffering. Now my anxiety is completely manageable. I just feel ‘normal’ for the first time in my life and I can function (leave my house, make phone calls, talk to people, work, completed my degree, etc).”
Jackie used a very slow taper to get off alprazolam:
“For 15 years I used Alprazolam (Xanax) 0.25 mg for sleep every night – couldn’t sleep without it. Five years ago, after reading about the long term cognitive effects of this drug, I spoke to my doctor and started to very slowly reduce the dose to stop. The doctor suggested to taper off over 2 weeks.
“Reading about tapering after years of daily usage left me concerned about doing it so quickly. My doctor worked with me over the next 5 months to do the following:
“I halved the dose for 2 months and then took that every other night and then halved it again for a few weeks. It took a while but I had no problems with anxiety or sleeplessness. BTW – getting off Xanax actually made me feel better cognitively – I think the drug made me mildly depressed and sluggish.”
Long-Term Benzo Side Effects:
While benzodiazepines can take the edge off, they may have long-term complications that health professionals are only now beginning to appreciate fully. A study published in PLoS One (June 29, 2023) describes a condition called benzodiazepine-induced neurological dysfunction or BIND for short.
The researchers analyzed the results from an online survey of over 1,200 people who had taken benzo-type drugs. The majority reported lingering symptoms, even after discontinuing the meds. Problems such as anxiety, nervousness, sleep difficulties, low energy and trouble focusing were most common. Even after a year off the anti-anxiety agents, many people complained about memory loss, digestive issues and body aches.
Some physicians might blame these complaints on a resurgence of the original condition.
But the authors of the latest research note:
“A significant subpopulation of respondents with BIND reported multiple and severe symptoms, many of which were not the symptoms for which the benzodiazepines were originally prescribed.”
One reader reported her experience after 20 years on lorazepam:
“My symptoms were insomnia, irritability, dizziness, shakiness and anxiety. It seems I was impossible to live with. I quit because I was especially concerned about memory loss, sleep walking and zoning out as if I were in another world.”
Stopping Anti-Anxiety Benzos Requires Professional Help!
Initially, health care providers did not realize that stopping a benzo could result in significant withdrawal symptoms. Now, however, there is general recognition that people who take benzodiazepines may have difficulty stopping these drugs too quickly. Withdrawal symptoms include sleeplessness, heart palpitations, tremors and severe agitation.
Another reader shared:
“The nightmare of withdrawing from a benzo is extremely real! I was on Xanax once a day for 20 years. When I had trouble stopping, the doctor prescribed Valium for the dizziness. I took it for another six years.
“Finally, I tapered myself slowly. I’ve been off now 10 months, but I still have horrible symptoms. My worst are dizziness/no balance and severe insomnia.
“I was ignorant as to the trouble I would face after being on this drug. I feel for anyone going through this torture. I pray every day I live long enough to come out of this as a normal functioning person so I can enjoy what life I have left.”
The new research confirms that some people experience long-lasting adverse consequences even after discontinuing the medication. This should alert patients and prescribers to the dangers of this popular class of anti-anxiety drugs.
People should never stop taking benzodiazepine-type drugs suddenly on their own. And some people will have to continue taking benzos for years or decades.
If it becomes necessary to phase off an anti-anxiety benzo, the “Ashton Manual” can be a useful tool. A knowledgeable health professional who can assist in the tapering process is also critical. Learn more about Dr. Heather Ashton and her approach at this link.
Please Share Your Story:
We would very much like to learn about your experience with benzodiazepines. How have they been helpful and how have such drugs caused you problems? Please share your story below in the comment section below. Thank you.