Benzodiazepines and Z-Drugs - Information for Patients

Benzodiazepines are medications such as diazepam, lorazepam, temazepam and nitrazepam.

Z drugs are medicines such as zopiclone and zolpidem

Prescribers at this practice will prescribe benzodiazepines and z-drugs in line with NICE (1) and locally developed guidelines:

First line treatment should be non-medication measures such as sleep hygiene (good routine before bed), mindfulness and meditation techniques for which help can be found at the following

Sleeping problems

If this is a new medication, we will prescribe for a maximum of 14 days at the lowest effective dose
The reason for starting the medication will be documented in your medical notes
Other causes of sleep disturbance (pain, shortness of breath, depression) will be recorded and treated appropriately
You will be advised on non-drug therapies for anxiety and insomnia via Mindwell and LMWS
You will be advised on the potential problems of dependence (addiction)
A second prescription will not be issued without a follow up consultation with a clinician
These medications should not be taken for longer than 2-4 weeks including reducing the dose to eventually stop taking it

If benzodiazepines are being prescribed for back spasm (2):

The dose is 2mg diazepam upto three times per day when required for muscle spasm. If necessary this can be increased upto 5mg three times per day.
Maximum 2-5 day course is recommended due to the high risk of side effects and addiction to this medication
If you are elderly or frail, further consideration may be given to the dose due to the increased risks of falls associated with these medications

Benzodiazepines for phobias including fear of flying:

Benzodiazepines are contra-indicated for use in phobic states and should not be prescribed for events such as flying (3)
Benzodiazepines can be sedating but an uncommon side effect is agitation and a rare side effect is aggression and a change in behaviour that may negatively impact on patient safety as well as that of other passengers
To help tackle fear of flying please see below courses run by airlines

FF VSL-LF GBP

Repeat prescriptions:

Prescriptions for benzodiazepines and z drugs should not be routinely available on repeat prescriptions.
The aim of the practice is to assess those that do have them on their repeat prescription and if appropriate agree a withdrawal scheme with the aim to gradually reduce the medication to nothing, where appropriate.
If you are taking these types of medications and wish to reduce or stop, please contact the surgery to arrange a routine appointment. Please DO NOT stop your medication suddenly as you may develop withdrawal symptoms such as agitation, insomnia and fits.
There are a small number of people who it may be appropriate to continue on small doses of benzodiazepines or z-drugs including those with severe mental health problems under the care of a psychiatrist, use for treatment of epilepsy, are seriously or terminally ill

Misuse of Medication

These medications have the potential for misuse and as such lost prescriptions will not be replaced
If you take higher doses than prescribed and run out of medication before the next prescription is due, you will not be prescribed extra tablets and a routine appointment to discuss this further is advised
Prescriptions requested early for travel will require proof of travel

Safety:

These medications can cause drowsiness and impaired ability to act and behave safely therefore if you experience these side effects you must not drive. Further information can be found at

Alcohol increases the chances of you experiencing the drowsiness effects of this medication therefore it as advised to avoid alcohol when starting on this medication