I'm an anxiety and depression sufferer since last 2 years and i'm on antidepressants since then . Antidepressants helps me alot but i'm still stressed out or not same . Whenever I take any benzodiazepines like alprozopam or clonazepam I feel good . But I afraid to take benzos regularly. My question is can benzodiazepines be taken lifelong like antidepressants ?

Dr. Sushil Kumar S VPsychiatrist13yrs exp

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The effects of long-term benzodiazepine use include drug dependence as well as the possibility of adverse effects on cognitive function, physical health, and mental health. Benzodiazepines are generally effective when used therapeutically in the short-term. Most of the problems associated with benzodiazepines result from their long-term use. There are significant physical, mental and social risks associated with the long-term use of benzodiazepines. Although anxiety can temporarily increase as a withdrawal symptom, there is evidence that a reduction or withdrawal from benzodiazepines can lead in the long run to a reduction in anxiety symptoms. Due to these increasing physical and mental symptoms from long-term use of benzodiazepines, slowly withdrawing from benzodiazepines is recommended for many long-term users. Not everyone, however, experiences problems with long-term use. Some of the symptoms that could possibly occur as a result of a withdrawal from benzodiazepines after long-term use include emotional clouding, flu-like symptoms, nausea, headaches, dizziness, irritability, lethargy, sleep problems, memory impairment, personality changes, aggression, depression, social deterioration as well as employment difficulties, while others never have any side effects from long term benzodiazepine use. One should never abruptly stop using this medicine and should wean themself down to a lower dose under doctor supervision. While benzodiazepines are highly effective in the short term, adverse effects in some people associated with long-term use including impaired cognitive abilities, memory problems, mood swings, and overdoses when combined with other drugs may make the risk-benefit ratio unfavourable, while others experience no ill effects. In addition, benzodiazepines have reinforcing properties in some individuals and thus are considered to be addictive drugs especially in individuals that have a" drug-seeking" behavior; in addition, a physical dependence can develop after a few weeks or months of use. Many of these adverse effects of long-term use of benzodiazepines begin to show improvements three to six months after withdrawal. Other concerns about the effects of long-term benzodiazepine use, in some, include dose escalation, benzodiazepine abuse, tolerance and benzodiazepine dependence and benzodiazepine withdrawal problems. Both physiological tolerance and dependence can lead to a worsening of the adverse effects of benzodiazepines. Increased risk of death has been associated with long-term use of benzodiazepines in several studies, however, other studies have not found increased mortality. Due to conflicting findings in studies regarding benzodiazepines and increased risks of death including from cancer, further research in long-term use of benzodiazepines and mortality risk has been recommended. Most of the research has been conducted in prescribed users of benzodiazepines; even less is known about the mortality risk of illicit benzodiazepine users. The long-term use of benzodiazepines is controversial and has generated significant controversy within the medical profession. Views on the nature and severity of problems with long-term use of benzodiazepines differ from expert to expert and even from country to country; some experts even question whether there is any problem with the long-term use of benzodiazepines. However, if you are using benzodiazepines according to prescription and not overusing them, i. E. Not using as needed in increasing doses to relieve your anxiety, you are at no higher risk compared to other antidepressants. 

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