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Sleeping Tablets, Benzos and other ‘Z’ Drugs

What are benzodiazepines and “Z” drugs and what are they used for?

Benzodiazepines are a group of medicines which are often used to treat anxiety e.g. diazepam, or used as sleeping tablets e.g. temazepam or nitrazepam. The “Z” drugs (zopiclone, zolpidem and zaleplon) are other sleeping tablets that are similar to benzodiazepines in how they work. These medicines can be effective at easing the symptoms of anxiety or aiding sleep and are meant for short-term use i.e. 2-4 weeks. You should
only take these medicines if your doctor has prescribed them for you – do not take medicines intended for other people. Illegal versions of these are also available via the internet or on ”the street”. Common street names include: Valium, vallies, diazzies, blues, yellows, sleepers, benzos, Mogadon, temazzies, fives, tens, wee yellow men, downers. The quality of these is unknown and you should not buy or take these.

What happens if you take a benzodiazepine or “Z” drug for longer than 4 weeks?

You can usually stop taking one of these medicines without any problems if you only take them for 2-4 weeks. Longer use may cause problems such as tolerance and/or dependence.

If you take a benzodiazepine or “Z” drug regularly, after a few weeks the body and brain become used to it and the drug gradually loses its effect. You then need a higher dose for it to work in the same way. In time, the higher dose will not work and you will need an even higher dose. This effect is called tolerance.

Because of “tolerance”, the tablets may not help your original sleeping or anxiety problem if you take them for a long time.

There is a good chance that if you take a benzodiazepine or “Z” drug for more than 4 weeks you will become dependent on them. This means that withdrawal symptoms can occur if the tablets are stopped suddenly and these may include:
– anxiety
– panic attacks
– odd sensations
– feelings of unreality
– feeling awful
– hearing and visual disturbance
– inability to sleep
– sweating
– headache
– tremor
– feeling sick
– palpitations
– muscle spasms
You may end up taking more medication to prevent withdrawal symptoms.

Benefits of stopping benzodiazepines or “Z” drugs

Stopping these medicines can have many benefits for
your health including:
– Improved memory and reaction times
– Higher levels of alertness and enjoyment of life
– More energy and ability to do things

Stopping benzodiazepines or “Z” drugs

It is best to talk to your doctor or pharmacist about how to come off benzodiazepines or “Z” drugs. Some people can stop taking them without any difficulty. However, to keep withdrawal effects to a minimum, it is often best to reduce the dose gradually over a number of weeks or months before finally stopping. Withdrawal symptoms may last for just a few days, but in some people can last for many weeks. Symptoms may not start for up to 2 days after stopping your tablets and tend to be worse in the first week or so.

Practical Advice when you are coming off benzodiazepines or “Z” drugs

You may have disturbed sleep when you are coming off the tablets. Try to anticipate and accept this
– Consider telling friends and family that you are stopping the tablets. They may give you encouragement and support
– Consider joining a local self-help group. Advice and support from other people in similar circumstances can be very helpful
– Avoid taking extra tablets in times of stress
– Do not make up for the lack of tablets by drinking alcohol, taking other drugs (prescription, non-prescription or illicit) or smoking

Alternatives to benzodiazepines and “Z” drugs

Benzodiazepines offer short term relief of problems and your doctor may only prescribe these drugs for a short period of time to help you cope while your symptoms are severe. If you experience ongoing problems, it makes sense to start thinking about other ways of coping. You may consider:
– Regular exercise
– Listening to music
– Learning relaxation techniques
– Counselling / Cognitive Behavioural Therapy
– Self help guides and groups
– Follow the ‘Good Sleep Guide’ available from your GP Surgery, NHS website or Community Pharmacy

Please see the help and support section of our website for further information.