Patient information from BMJ

Benzodiazepine overdose

Last published:Mar 27, 2023

Benzodiazepine medicines are often prescribed for conditions including insomnia and anxiety. An overdose happens when someone takes too much in a short period.

This can happen by accident or as a suicide attempt. Most people recover well with treatment, but a large overdose can sometimes lead to serious problems and even death.

If you are concerned about the dangers of benzodiazepines, either for you or someone else, you can use our information to talk to your doctor.

What is benzodiazepine overdose?

Benzodiazepines help to calm and 'slow down' the body’s nervous system. They are often broadly known as 'sleeping tablets' or 'tranquilisers'. But they are prescribed for many conditions, including :

• Insomnia

• Anxiety

• Seizures

• Panic disorder, which causes panic attacks, and

• Conditions that involve muscle spasms.

Benzodiazepines are also often prescribed for post-traumatic stress disorder (PTSD), even though the evidence suggests that they don’t work for this condition.

They are also commonly abused as recreational drugs, often alongside alcohol or opioids.

Benzodiazepines are controversial. Doctors know that they can cause problems such as addiction, and dizziness, which can lead to falls. But they are still widely prescribed, possibly because sometimes there doesn’t seem to be a good alternative.

For most people, benzodiazepines should only be prescribed for short periods. But many people end up taking them for much longer.

An overdose can happen:

• Accidentally, when someone takes too high a dose in a short time, or if they are given too high a dose in hospital

• As an act of self-harm, such as a suicide attempt, or

• If someone (usually an older person) has liver problems, and their liver can’t cope with even a normal dose of the drug.

What are the symptoms?

The main symptom of a benzodiazepine overdose is what doctors call excessive sedation. This means that someone becomes extremely drowsy. Other symptoms include:

• Slurred speech

• Poor coordination

• Being unsteady on your feet, and

• Struggling to pay attention or to remember things.

A large overdose can cause much more serious problems, such as coma, and breathing problems. Without treatment, this can lead to death.

What treatments are available?

Most people who have a benzodiazepine overdose don’t need any specific treatment, other than being watched in hospital until the effects of the drug wear off, to make sure their symptoms don’t get worse.

If you have severe symptoms, such as being in a coma, or you aren’t breathing properly, you will need extra help to deal with those problems.

Some people are given charcoal tablets to swallow. Charcoal absorbs drugs in your stomach and intestine, so that they don’t get into your system. But they only work if you take them within about an hour of having an overdose.

Most people can be discharged within a few hours of an overdose. But if your overdose was a deliberate act of self-harm, you will need to stay in hospital until a psychiatrist or psychologist can see you.

They will talk with you, and assess if you might be likely to harm yourself again. If they think that you might, then you might have to stay in hospital until your doctor thinks it’s safe for you to leave.

What to expect in the future

If, after being treated for an accidental overdose, you still need to take benzodiazepines for medical reasons, your doctor should recommend that you take a different one from the one that led to the overdose.

There are several benzodiazepines, so there are several others that you can try, to try to avoid problems.

If your doctor thinks that you shouldn’t be taking benzodiazepines any more, they might recommend that you slowly reduce your dose until you stop taking them completely.

You can talk to your regular doctor about how to do this, and about what you might be able to take instead.

Most people recover well after an overdose of these drugs. But if you took a deliberate overdose, dealing with the issues that led to it could take time. And you might need a lot of help.

If you have become dependent on benzodiazepines, your doctor should also talk with you about getting help to stop taking them.

Doctors know that it can be hard to stop taking these drugs. So they should be understanding about the difficulties you might face.