 Anxiolytic
 Works on the CNS by acting selectively on
gamma-aminobutyric acid-A (GABA-A)
receptors in the brain by making the
neuron negatively charged and resistant to
 They are used as sedatives, hypnotics,
anxiolytics, anticonvulsants, and muscle
 Examples: Xanax, Ativan, Klonopin,
Valium, Versed
 Introduced around 1960 with the
marketing of chlordiazepoxide (Librium)
and followed by its derivative diazepam
 Replaced older more unsafe sedatives like
 It is a chemical compound made in
laboratories of pharmaceutical companies
 Acute toxicity of benzodiazepines are
extremely low, even in large doses
 Acute toxicity symptoms: confusion,
dizziness, poor judgment and decision
making, lack of coordination, slurred
speech, difficulty breathing, weakness,
 Chronic toxicity will change a person’s
appearance and behavior which affects
their relationships and work performance
 Chronic abuse symptoms: anxiety,
insomnia, anorexia, tremors, headaches,
weakness, and memory problems
 Symptoms of overdose – dizziness,
confusion, drowsiness, blurred vision,
unresponsiveness, anxiety, and agitation
 Physical exam findings for overdose nystagmus, hallucinations, slurred speech,
ataxia, hypotonia, weakness, altered
mental status, amnesia, respiratory
depression, paradoxical agitation,
hypotension, coma
 Antidote is flumazenil (Romazicon) –
specific for benzodiazepine poisoning and
acute overdose; controversial because the
risk usually out weight the possible
 The best treatment for benzodiazepine
overdose is good supportive care and
monitoring of patient
 Very rarely fatal for benzodiazepine
overdose but biggest concern is aspiration
with altered mental status
 May begin 12-24 hours after the last dose
received, reaches peak intensity between
24 and 72 hours
 Signs and symptoms: Autonomic
hyperactivity (sweating, HR >100), hand
tremors, N/V, illusions, hallucinations,
anxiety, grand mal seizures, fear, rapid
mood changes, insomnia, hand tremors,
and constipation
 Hospitalization is usually not required
unless rare, but severe symptoms such as
seizures occur
 Medications are usually not used for the
withdrawal from benzodiazepines.
 Slowly lowering the doses of the
substance is best to decrease the amount
and severity of symptoms.
Benzodiazepines. (2015). Retrieved from
Benzo Withdrawal: The Ultimate Guide to Symptom Relief. (2015). Retrieved from
Dryden-Edwards, Roxanne. Benzodiazepine Abuse. (2014, December 12). Retrieved
Townsend, M. C. (2015). Psychiatric mental health nursing: Concepts of care in
evidence-based practice (8th ed.). Philadelphia, PA: F. A. Davis.
Withdrawal syndrome: Benzodiazepines. Reconnection- Treating Panic, Anxiety,
Depression, and Tranquilizer dependency. (2013). Retrieved from