This article explains what benzodiazepines are, how tolerance and dependence on anxiety medication can develop, what withdrawal symptoms can look like, and how to talk to a doctor about reducing benzodiazepines safely.
Benzodiazepines are a type of anxiety medication, such as diazepam and lorazepam, prescribed for severe anxiety. According to the NHS, benzodiazepines should usually only be used short term, up to 4 weeks, because the body can become used to this anxiety medication and it stops working as well. Taking benzodiazepines for longer can lead to tolerance, dependence, withdrawal symptoms and, for some people, addiction, so any change to anxiety medication should be planned with a doctor.
Key takeaways
1. Benzodiazepines such as diazepam and lorazepam are anxiety medication meant for short-term use, usually no longer than 4 weeks.
2. Benzodiazepine tolerance means a higher dose is needed to get the same calming effect.
3. Withdrawal symptoms from anxiety medication can look like the original problem, which can make it hard to tell whether the tablets are still helping.
4. Benzodiazepines should not be stopped suddenly, as stopping suddenly can cause withdrawal symptoms such as confusion or seizures.
5. UK clinical guidelines ask doctors to reassure people that dependence is an expected effect of benzodiazepines, not a personal failure.
What Are Benzodiazepines?
Benzodiazepines are prescription anxiety medication with calming, sedating and muscle-relaxing effects. According to the NHS, a benzodiazepine such as lorazepam works by increasing the effect of a calming chemical in the brain, which can help a person feel more relaxed or sleepy. Benzodiazepines are only available with a prescription.
Benzodiazepines used for anxiety, sometimes called anti anxiety meds, include diazepam, alprazolam, chlordiazepoxide, lorazepam and oxazepam, according to the NICE Clinical Knowledge Summary on benzodiazepine withdrawal. Diazepam can also be prescribed for seizures, muscle spasms and alcohol withdrawal, and as a sedative before treatment or surgery. Other benzodiazepines, such as temazepam, are prescribed for sleep problems.
Is All Anxiety Medication a Benzodiazepine?
No. Benzodiazepines are only one type of anxiety medication. According to NHS advice on generalised anxiety disorder (GAD), the anxiety medication a GP usually offers is a type of antidepressant called an SSRI, and a GP will usually suggest talking therapies, such as cognitive behavioural therapy (CBT), before prescribing anxiety medication.
The UK guideline on generalised anxiety disorder and panic disorder (CG113) advises against prescribing a benzodiazepine for generalised anxiety disorder except as a short-term measure during a crisis. The same guideline states that benzodiazepines are linked to a less good long-term outcome for panic disorder and should not be prescribed for panic disorder.
How Long Should Benzodiazepines Be Taken?
Benzodiazepines are anxiety medication for short-term use only, and the length of a prescription matters for tolerance and dependence. The NHS states that diazepam should only be used for up to 4 weeks, because taking this anxiety medication for longer can cause addiction, dependence and withdrawal symptoms. The NHS page on lorazepam explains that lorazepam is usually not prescribed for more than 4 weeks because the body can become used to lorazepam and it stops working as well.
What Is Benzodiazepine Tolerance and Dependence?
Benzodiazepine tolerance means that a higher dose is needed to get the same effect as at the start of treatment. Benzodiazepine dependence means a person feels they need their anxiety medication to get through day-to-day life, or experiences withdrawal symptoms when the dose is reduced or stopped. The NICE Clinical Knowledge Summary describes both tolerance and dependence as possible effects of taking this anxiety medication long term, usually more than 4 weeks.
Tolerance to benzodiazepines can feel confusing. A tablet that once brought relief quickly may seem to work less and less, while life without it feels harder to cope with. Tolerance and dependence on anxiety medication can develop even when the tablets are taken exactly as prescribed, so tolerance is not a sign that a person has done something wrong.
Can You Become Addicted to Anti Anxiety Meds?
Yes, some anti anxiety meds can lead to addiction. The NHS states that it is possible to become addicted to lorazepam, and that taking diazepam for longer than 4 weeks can cause addiction and withdrawal symptoms. To reduce the risk of addiction and dependence, doctors usually prescribe benzodiazepines for a short time and at the lowest dose needed.
Dependence on anxiety medication is not the same as addiction. Dependence describes tolerance and withdrawal symptoms, while addiction adds cravings, loss of control and continuing to take a drug despite harm. Our article The Difference Between Dependence and Addiction (https://www.noveya.co.uk/blog/the-difference-between-dependence-and-addiction) explains the difference between dependence and addiction in more detail.
When Anxiety Medication Stops Working: What We Often Hear at NOVEYA
Barbara Zadworna, Founder of NOVEYA, describes what many people go through when anxiety medication starts to work less well:
"Many people describe a moment when a medication that once brought relief almost immediately gradually started to work less and less, and without it, anxiety felt even harder to bear. That is when a very difficult question appears: am I still taking this medication because it helps me, or because I am afraid of what will happen when it runs out?"
Why Is It So Hard to Talk to a Doctor About Anxiety Medication?
"For many people, the hardest part is the conversation with a doctor," says Barbara. "Fear of being judged, fear of hearing 'you are addicted', but above all panic about having the prescription suddenly taken away can mean the problem stays unspoken for a long time."
"Sometimes a person does not need another warning, but a doctor who says: 'I believe you, I will not leave you alone with this, and we will find a safe solution.' With benzodiazepine dependence, being able to tell the truth without shame or fear can be the first step towards feeling safe again."
UK clinical guidelines support this approach. The guideline on medicines associated with dependence (NG215) asks doctors to understand that people may feel reluctant or anxious about discussing dependence, to reassure them that dependence is an expected effect of benzodiazepines, and to avoid language that may blame the person. NG215 also states that benzodiazepines and other medicines associated with dependence should not be stopped abruptly, except in exceptional medical circumstances.
What Are the Withdrawal Symptoms of Benzodiazepines?
Withdrawal symptoms from benzodiazepines are the physical and mental reactions that can appear when anxiety medication is reduced or stopped, and withdrawal symptoms are a common sign of dependence. According to the NICE Clinical Knowledge Summary, substance withdrawal symptoms after benzodiazepines can include:
1. Anxiety and panic attacks.
2. Difficulty sleeping (insomnia).
3. Sweating, shaking (tremor) and palpitations.
4. Headache and feeling sick (nausea).
5. Low mood or depression.
6. Rarely, psychosis or seizures.
Withdrawal symptoms from anxiety medication can mimic the original condition the tablets were prescribed for. NG215 notes that withdrawal symptoms can be difficult to tell apart from a return of the original symptoms, and that such withdrawal symptoms should be discussed with a healthcare professional. The risk of withdrawal symptoms increases with longer use, a higher dose and a stronger benzodiazepine.
Benzodiazepine withdrawal symptoms do not affect everyone. According to NG215, it is not possible to predict who will have withdrawal symptoms, and the safe pace of reducing anxiety medication varies between people and can change over time for the same person.
What Are the Risks of Taking Benzodiazepines Long Term?
Long-term use of benzodiazepines can affect memory, concentration and everyday functioning. The NICE Clinical Knowledge Summary lists possible effects such as over-sedation, which increases the risk of falls and accidents, memory problems, emotional blunting, reduced coping skills and depression. Older people are more vulnerable to these effects of benzodiazepines.
Mixing benzodiazepines with alcohol or other drugs increases the risks of dependence and harm. The NHS warns that drinking alcohol while taking lorazepam can cause breathing problems and make it very difficult to wake up. NG215 lists taking an opioid together with a benzodiazepine as a factor that may increase the risk of problems with dependence.
How Can Benzodiazepines Be Reduced Safely?
Reducing anxiety medication safely means lowering the dose slowly, with a plan agreed with a prescriber, to limit withdrawal symptoms and support recovery from dependence. These steps reflect UK clinical advice:
Step 1: Do not stop benzodiazepines suddenly on your own, as this can trigger withdrawal symptoms. The NHS warns that stopping lorazepam suddenly can cause withdrawal symptoms such as confusion or seizures, and that a doctor will reduce the dose gradually so lorazepam can be stopped safely with fewer withdrawal symptoms.
Step 2: Talk to your GP or prescriber honestly about dependence. NG215 recommends that any reduction of anxiety medication is agreed through shared decision-making, with enough time to discuss the person's circumstances and preferences.
Step 3: Agree a slow, stepwise plan for reducing benzodiazepines. For benzodiazepines, NG215 suggests a slow reduction in which each step becomes smaller as the dose gets lower. A doctor may also consider switching from a short-acting benzodiazepine to a longer-acting one.
Step 4: Ask about talking therapy. NG215 recommends considering group cognitive behavioural therapy (CBT) during benzodiazepine withdrawal, which can help people cope with dependence and withdrawal symptoms. Adults in England can also refer themselves to NHS talking therapies without a GP referral.
Step 5: Avoid alcohol and tell your doctor about any other medicines. Alcohol and opioid painkillers can increase the risks of benzodiazepines, so a doctor or pharmacist should know about everything you take.
What the Guidelines Say
Benzodiazepines are short-term anxiety medication: the NHS states that diazepam should only be used for up to 4 weeks, that taking diazepam for longer can cause addiction and withdrawal symptoms, and that benzodiazepines should not be stopped suddenly because stopping suddenly can cause withdrawal symptoms.
In Short
Benzodiazepines such as diazepam and lorazepam can ease severe anxiety in the short term, but taking this anxiety medication for longer than a few weeks can lead to tolerance, dependence, withdrawal symptoms and, for some people, addiction. Withdrawal symptoms from anxiety medication can feel like the original condition, so reducing anxiety medication should be planned slowly with a doctor. At NOVEYA, we believe that being able to talk about dependence on anxiety medication without shame or fear can be the first step towards feeling safe again.
Our article Prescription Drug Addiction: When Medication Becomes a Problem (https://www.noveya.co.uk/blog/prescription-drug-addiction) looks at other types of prescription drugs associated with dependence. Our article Sleeping Tablets and Dependence: Recognising the Warning Signs (https://www.noveya.co.uk/blog/sleeping-tablets-and-dependence) looks at dependence on sleeping tablets, and Pain Killers and Dependence: What You Need to Know (https://www.noveya.co.uk/blog/painkillers-and-dependence) looks at opioid painkillers.
At NOVEYA, understanding comes first, support follows, and change becomes possible once support is there.
Frequently Asked Questions
Will my doctor stop my anxiety medication suddenly if I say I am dependent?
NG215 states that medicines associated with dependence, including benzodiazepines, should not be stopped abruptly except in exceptional medical circumstances. Talking openly about dependence is the first step towards a safe, gradual plan to reduce anxiety medication and limit withdrawal symptoms.
How long do benzodiazepine withdrawal symptoms last?
There is no single answer. According to NG215, it is not possible to predict who will have withdrawal symptoms, and the safe pace of reducing anxiety medication varies from person to person. A doctor can adjust a reduction plan so that difficult withdrawal symptoms can settle before the next step.
Can I drink alcohol while taking benzodiazepines?
No. The NHS advises not to drink alcohol while taking diazepam or lorazepam, because alcohol can increase the side effects, and with lorazepam it can cause breathing problems.
Are there other treatments besides anxiety medication?
Yes. According to the NHS, talking therapies such as cognitive behavioural therapy (CBT) are usually tried before anxiety medication for generalised anxiety disorder. Adults aged 18 and over can refer themselves to NHS talking therapies for anxiety and depression.
Can I take anti anxiety meds with pain killers?
Only if a doctor has agreed this combination, because mixing them can increase the risk of dependence. The NHS lists opioid painkillers such as codeine among the medicines that may not mix well with lorazepam, and NG215 lists taking an opioid with a benzodiazepine as a risk factor for problems with dependence.
What should I do if I have taken too much anxiety medication?
Taking an extra dose of a benzodiazepine can be dangerous. The NHS advises calling NHS 111 if you have taken more than your prescribed dose. If you are told to go to A&E, do not drive: ask someone to drive you or call 999 for an ambulance.
About This Article
Barbara Zadworna is the Founder of NOVEYA, bringing together a Bachelor's degree in Psychology and Criminology, professional experience supporting people in a psychiatric hospital setting, specialist training in Addiction Therapy and Psychological First Aid (2026), and personal lived experience of addiction and recovery.
If you would like to talk to someone or find out more about the support NOVEYA offers, get in touch (support@noveya.co.uk).
Sources
NHS guidance on diazepam.
NHS guidance on lorazepam.
NHS guidance on generalised anxiety disorder (GAD) in adults.
NICE (2022) Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults (NG215).
NICE (2011) Generalised anxiety disorder and panic disorder in adults: management (CG113).
NICE Clinical Knowledge Summaries: Benzodiazepine and z-drug withdrawal.