Benzodiazepines for Anxiety: What to Know

Key points

Alprazolam, lorazepam, clonazepam and diazepam are benzodiazepines, and their labels list them as Schedule IV controlled substances.
Their labeled uses differ: for example, clonazepam's anxiety-related use is panic disorder.
The boxed warning covers opioid combinations, abuse and addiction, and dependence and withdrawal.
NIMH says providers usually prescribe them for short periods and taper them slowly.
Stopping suddenly after continued use can cause withdrawal reactions that can be life-threatening.

What benzodiazepines are

Benzodiazepines are a group of medicines that can cause sedation. The National Institute of Mental Health (NIMH) describes them as a common type of anti-anxiety medication used for some short-term anxiety symptoms, and says they are sometimes used for generalized anxiety disorder.

They are different from antidepressants such as SSRIs, which NIMH says usually take weeks to work. NIMH describes benzodiazepines as useful as needed for severe short-term anxiety. The risks below are why a careful conversation with a prescriber matters.

What the labels say they are for

FDA labels differ from one benzodiazepine to the next, so a general statement about the group can mislead. These are the anxiety-related uses listed on each label.

Alprazolam (Xanax): acute treatment of generalized anxiety disorder and treatment of panic disorder, with or without agoraphobia, in adults.
Lorazepam (Ativan): management of anxiety disorders, or short-term relief of anxiety symptoms or anxiety associated with depressive symptoms.
Clonazepam (Klonopin): panic disorder, with or without agoraphobia. Its label also covers certain seizure disorders.
Diazepam (Valium): treatment of anxiety disorders and short-term treatment of anxiety symptoms. Its label lists other uses too.

The boxed warning in plain words

A boxed warning appears at the top of a medicine's FDA label. It applies to everyone taking a benzodiazepine, and it covers three main risks.

Combining with opioidsTaking a benzodiazepine with an opioid may cause profound sedation, slowed breathing, coma and death. Tell your prescriber about any opioid pain or cough medicine you take.
Abuse, misuse and addictionUse can lead to overdose or death. The labels say misuse commonly involves other medicines, alcohol or illicit substances, which raises the risk of serious harm. Prescribers are told to assess this risk before and during treatment.
Dependence and withdrawalContinued use may lead to physical dependence. The labels say the risks increase with longer treatment and higher daily doses, and that stopping suddenly or reducing quickly can cause withdrawal reactions that can be life-threatening.

Why they are generally short-term

NIMH says taking benzodiazepines over long periods may lead to tolerance or dependence, so providers usually prescribe them for short periods and taper them slowly. Tolerance means needing more of a medicine to get the same effect.

The labels also speak to duration. The lorazepam label says its effectiveness in use beyond 4 months has not been assessed by systematic clinical studies, and the clonazepam label says effectiveness beyond 9 weeks has not been systematically studied in controlled trials. Both ask the prescriber to reassess usefulness over time.

This does not mean everyone's situation is identical. It does mean that if you take one of these medicines, a regular review with your prescriber is a normal and sensible part of care.

Never stop suddenly

Please do not stop a benzodiazepine or lower the dose on your own, even if you feel fine or are worried about dependence. The alprazolam label says withdrawal can include seizures. FDA labels call for a gradual, individual taper when a medicine is being reduced or discontinued.

If you want to come off a benzodiazepine, that is a reasonable thing to raise. Your prescriber can make a plan and support you through it. Being honest about how much you take and how long you have taken it helps keep that plan safe.

Other things worth telling your prescriber

All other medicines, including opioids and sleep medicines.
Any alcohol use or past trouble with medicines or other substances.
Glaucoma or liver disease. Some labels list certain forms of these as reasons not to use a specific medicine.
If you are pregnant, planning a pregnancy or breastfeeding.

Side effects to know about

The most common side effects vary by medicine. The labels and patient guides list problems with coordination, low blood pressure, slurred speech and changes in sex drive for alprazolam; sedation and dizziness for lorazepam; drowsiness, dizziness, depression, fatigue and memory problems for clonazepam; and drowsiness, fatigue and muscle weakness for diazepam.

Because these medicines can make you drowsy or less alert, ask your prescriber about driving or other tasks that need your full attention.

Rules, online care and how we can help

Benzodiazepines are Schedule IV controlled substances. As of November 2026, a temporary federal rule (Federal Register, Fourth Temporary Extension) allows DEA-registered practitioners to prescribe Schedule II to V medicines by audio-video telemedicine without a prior in-person evaluation, under set conditions, through December 31, 2026. Rules may change after that date. Read more in our guide on whether benzodiazepines can be prescribed online. Each medicine also has its own page, such as alprazolam and clonazepam.

A licensed psychiatrist on our team treats anxiety online by secure video for people physically located in Pennsylvania or New York during each visit. Whether a benzodiazepine is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help: contact us about medication care, or read about online anxiety treatment. If you are in crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services.

Common questions

Are benzodiazepines addictive?

They can be. The FDA boxed warning says use exposes people to risks of abuse, misuse and addiction, which can lead to overdose or death, and that continued use may lead to physical dependence. Talk openly with your prescriber about any worries you have.

How long can someone take a benzodiazepine?

There is no single answer. NIMH says providers usually prescribe them for short periods and taper them slowly, and labels describe limits on how long effectiveness has been studied. Your prescriber should reassess the benefit and risks with you over time. Please do not stretch or cut a course on your own.

What should I do if I want to come off a benzodiazepine?

Talk with your prescriber before changing anything. Labels warn that stopping suddenly or reducing quickly after continued use may cause withdrawal reactions that can be life-threatening, so a gradual plan is needed. If you develop severe symptoms, such as a seizure, call 911 right away. Wanting to change your plan is a welcome conversation to have.

Can I drink alcohol while taking a benzodiazepine?

Ask your prescriber and be open about your drinking. The boxed warning says misuse of benzodiazepines commonly involves alcohol and is linked with more serious outcomes. Both can also make you drowsy. If alcohol use is hard to talk about, starting with a doctor you trust is a strong and ordinary step to take.

Sources

Published by Locascio Wellness. Published November 5, 2026. Clinically reviewed by Kenneth M. Levy, DO, Psychiatrist (Pennsylvania license OS007464L). This page is general information, not medical advice or a diagnosis.