Benzodiazepines are prescription medicines that are also called sleeping pills or anti-anxiety medicines. There are well-recognised harms from taking benzodiazepines long term. These include dependence, drowsiness, dizziness and falls.
For health professionals
- Non-medicine approaches such as cognitive behavioural therapy should be used first line for the treatment of anxiety disorders and insomnia.
- Taking a benzodiazepine beyond 4 weeks significantly increases the risk of dependence and should be prescribed with caution.
- Evidence of long-term therapeutic benefit from taking benzodiazepines is limited.
- For patients taking benzodiazepines longer term, support and education increases the likelihood of successful deprescribing.
- Download this template to design your own patient-focused benzodiazepine-reduction plan: Lowering your benzodiazepine dose.
Podcast – Benzodiazepines: Keep calm and prescribe responsibly
Podcast host Lynn Weekes discusses the risks of taking benzodiazepines long term, and how gradual dose tapering can be carefully and safely achieved in the primary care setting.
Podcast – Deprescribing in older people
Deprescribing is the process of discontinuing drugs that are either potentially harmful or no longer required. It can be achieved in older people and may be associated with improved health outcomes without long-term adverse effects.
Managing benzodiazepine dependence
- Benzodiazepine medicines can cause dependence.
- GPs play a key role in the safe use of benzodiazepines.
- Guidelines are available to help GPs identify and manage patients with benzodiazepine-related substance use disorder. Consider using the resources below to help identify and best manage patients with benzodiazepine dependence.
Clinical resources and tools
NPS MedicineWise: Benzodiazepine tapering algorithm and conversation starters (2022)
Australian Prescriber article: Management of benzodiazepine misuse and dependence
RACGP: Evidence-based guidance for benzodiazepines
PHN Tasmania: Guide to deprescribing
Reconnexion: The Benzodiazepine Toolkit
Reconnexion: Benzodiazepine dose equivalency chart
Research and references
Managing benzodiazepine dependence
The Royal Australian College of General Practitioners (RACGP)
Prescribing drugs of dependence in general practice. Part B- Benzodiazepines
Evidence-based guidelines by the RACGP outline a variety of clinical guidelines for appropriate benzodiazepine use based on the best available evidence.
This toolkit is designed for health practitioners to assist people who are dependent on benzodiazepines. Revised in 2018 this resource provides an extensive and up-to-date overview of all aspects of benzodiazepine use, dependence and withdrawal.
Alongside this resource is a collection of fact sheets to assist the consumer in understanding the condition the benzodiazepines are helping to manage alongside self-help strategies.
Therapeutic Guidelines – Principles of benzodiazepine use in anxiety disorders (subscription required to access)
Overview of current anxiety and associated disorder management. Outlines benzodiazepines role in therapy.
Pottie K, et al. Canadian Family Physician, 2018.
Deprescribing benzodiazepine receptor agonists – evidence based clinical practice guideline
Summation of evidence gathered from a systematic review of benzodiazepine deprescribing trials for insomnia. Includes a list of recommendations graded by quality of evidence available as well as clinical practice deprescribing guidelines.
Oude Voshaar OC, et al. Br J Psych, 2003.
Tapering off long-term benzodiazepine use with or without group cognitive behavioural therapy three-condition, randomised controlled trial
Randomised control trial reviewing the effectiveness of tapering benzodiazepines with and without the use of cognitive behavioural therapy.
Gould RL, et al. Br J Psych, 2014.
Systematic review and meta-analyses which examines the long-term use of benzodiazepines in older people and the methods of deprescribing in this population.