Can Benzodiazepines Cause Brain Damage?

Commonly prescribed benzodiazepines, such as Xanax, are used to treat anxiety disorders, insomnia, panic attacks, and seizures. Because they are highly addictive in nature, they shouldn’t be taken on a long-term basis.

Unfortunately, it only takes a week or so for a person’s body to start becoming physically dependent on benzodiazepines. An addiction to the medication is also possible, which can contribute to the development of a poly-substance use disorder.

One of the most common substances that people mix with Xanax and other benzodiazepines is alcohol. This is dangerous because of the potential damage that can be caused to the brain, since alcohol increases the effects of the medications. For this reason, it’s important for everyone who takes a benzodiazepine medication to learn how benzodiazepines can cause brain damage.

Even more dangerous is the combination of benzodiazepines with illicitly manufactured fentanyl, which now contaminates a wide range of street drugs. This combination accounts for the majority of benzo-involved overdose deaths. There were approximately 10,870 in 2023 according to NIDA, with roughly 70 percent also involving fentanyl. Unlike opioid overdose, benzo overdose cannot be reversed by naloxone alone, making prevention and medical supervision critical.

How Benzodiazepines Work In The Brain

One of the effects of benzodiazepines on the brain is that they increase the activity of the neurotransmitter gamma-Aminobutyric acid (GABA). GABA receptors are broadly classified into two main types: GABA-A (ionotropic) and GABA-B (metabotropic).

Benzodiazepines affect the GABA-A receptors the most. GABA-A receptors are concentrated in the limbic system and the cortex. Due to the way benzodiazepines affect GABA receptors, they may contribute to benzodiazepine brain damage when a person takes this type of medication, whether at one time or through continued use.

Slowing Brain Activity

Sometimes, people have a low level of GABA in their bodies because of certain medical conditions they have, such as Parkinson’s disease, ADHD, and anxiety. If they take benzodiazepines, it helps correct this problem by slowing down brain activity when GABA receptors bind to neurons within the brain.

For a person who is not struggling with one of these conditions, continually slowing brain activity can be damaging to a person’s normal brain processes. With time, a person may come to rely on the benzodiazepine for certain brain functions.

If dependence or addiction occurs, a person may find it difficult to restore normal brain activity as they enter recovery.

Depressing The Central Nervous System

The benzodiazepine receptors also cause the central nervous system to be depressed. They act as an anticonvulsant, which helps reduce the occurrence of seizures. Unfortunately, this same effect also contributes to amnesia, or memory loss, caused by benzodiazepines. Amnesia can sometimes be overcome, while other times, damage to a person’s memory may remain permanent.

A person’s individual chemical make-up and their use of other substances can also have an impact on how they are affected by benzodiazepines. Someone’s age, health issues, and the delivery method they use to get benzodiazepines into the body can all have an impact on their effects, too.

Side Effects Of Benzodiazepines

Some of the most common physical side effects of benzodiazepines include:

• lethargy
• dizziness
• vertigo
• impaired motor functioning
• slurred speech
• irritation of the veins when injected
• respiratory and cardiovascular depressant effects when combined with opioids or alcohol
• drowsiness
• ataxia
• trouble sleeping
• nightmares
• headaches
• nausea
• tremors
• diarrhea
• vomiting
• dry mouth
• increased risk of falls, particularly in older adults
• coma
• death when combined with opioids or alcohol
• weight gain
• skin rashes

Can Benzodiazepines Damage The Brain?

The short answer is “yes”. In fact, benzodiazepines can damage the brain in several ways. One way that benzodiazepines damage the brain is in regard to a person’s long-term memory.

There are several types of long-term memory. The type that is affected the most by benzodiazepines is a person’s episodic long-term memory. This refers to the important events in a person’s life and their memories of these events, such as their wedding day or the birth of their children. However, episodic memory loss can also sometimes affect a person’s ability to recall words and language rules they used to know.

Long-term benzodiazepine use has also been associated with an increased risk of dementia, particularly Alzheimer’s disease. A widely cited 2014 study published in the BMJ found that long-term benzo users had a 51 percent higher risk of developing dementia than non-users. Causality has not been definitively established, as anxiety and insomnia are themselves dementia risk factors. But the association is strong enough that many physicians now avoid prescribing benzodiazepines to older adults for this reason.

Another type of benzodiazepine brain damage is a sudden loss of inhibitions. This can be seen by a person suddenly taking risks and acting erratically. High-risk sexual activity and road rage are common.

Delirium and hallucinations that can’t be easily treated are possible benzodiazepine effects on the brain, too. These symptoms are a result of brain damage that occurs most often in the elderly who take benzodiazepines.

Many doctors consider these symptoms dangerous because they can increase the risk of an elderly person dying, especially if they have any other type of health problems while taking benzodiazepines.

Psychological Effects Of Benzodiazepines

The most common psychological effects of benzodiazepines include:

• anterograde amnesia
• rebound anxiety
• mood swings
• hostility
• erratic behavior
• disorientation
• confusion
• trouble concentrating
• cognitive impairment
• lack of motivation
• impaired thinking
• irritability
• personality changes
• depression

How Benzodiazepine Use Disorder Affects The Brain And Body

When benzodiazepines are misused by taking them in large doses or combining them with other substances, serious health problems due to central nervous system impairment can occur. Again, benzodiazepines can depress the central nervous system because of their impact on GABA in the brain.

In higher doses, a larger amount of GABA neurotransmitters will attach themselves to the GABA receptors. This will slow down neuronal activity in the areas of the brain that are responsible for controlling respiration, heart rate, and other important physical responses.

Alcohol and opiates increase the effects that benzodiazepines have on the body. If either of these substances is taken at the same time as a benzodiazepine, a person can end up dying from an overdose or going into a comatose state, from which they may never wake up.

The brain and body can also become impacted by benzodiazepine use disorder when a person becomes physically dependent on the medication. Within a week or so of taking benzodiazepines, the body’s systems will start to adapt to the presence of the substance. If a person suddenly stops taking their medicine, they will suffer from uncomfortable withdrawal symptoms, such as rebound anxiety.

Benzodiazepine withdrawal can be fatal. Unlike opioid withdrawal, abruptly stopping benzodiazepines after physical dependence has developed can cause life-threatening seizures and cardiac events. Anyone who has been taking benzodiazepines regularly, even as prescribed, should never stop suddenly without medical supervision. A physician-supervised taper is required, often over weeks or months, depending on duration of use and dosage.

Becoming physically dependent on benzodiazepines often results in a person starting to crave more of the medications so they can feel the same way they did when they first started taking them. This can cause them to use their prescription up faster than they are supposed to or illegally purchase the medications from drug dealers.

Treatment For Benzodiazepine Use Disorder And Addiction

Treatment for benzodiazepine use disorder typically begins with a medically supervised taper that gradually reduces the dose over time to minimize withdrawal risk. In some cases, physicians switch patients to a longer-acting benzodiazepine like diazepam (Valium) before tapering, which produces a smoother withdrawal curve.

Cognitive behavioral therapy (CBT) has strong evidence for treating the anxiety and insomnia that often underlie benzodiazepine misuse, and addressing these root conditions is essential for long-term recovery. Telehealth options are increasingly available for both supervised tapering and ongoing therapy, making treatment more accessible for those unable to attend in person.

Browse our directory or contact the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information about addiction recovery.

Written by the Addiction Resource Editorial Staff