Benzodiazepines for Anxiety Disorders | Dr. Jeffrey Knuppel

Benzodiazepines are an effective yet controversial treatment for anxiety and panic. In this video, I combine what I've learned about treating patients with anxiety disorders for many years (with benzodiazepines and other medications) with what research says about benzodiazepines (also known as "benzos") for the treatment of anxiety disorders. This class of medication includes medications such as alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin, Rivotril), diazepam (Valium), and others. In this video, I review how benzodiazepines work, how they are similar to and different from each other, what we know about what they are most effective at treating, and the possible side effects. I also discuss the "benzodiazepine conflict" that arises between patients and prescribers because these medications can provide immediate anxiety relief for many people yet carry risks that must be considered as well. Finally, I discuss why many prescribers are hesitant to prescribe alprazolam in particular.

I'm Dr. Jeff Knuppel, a psychiatrist (M.D.) with over 20 years of practice experience. I'm a licensed healthcare professional (physician) in Wisconsin, USA. My goal is to create helpful and interesting videos about mental health and self-improvement. If these topics interest you, please subscribe so that you don't miss any new videos when they are released. Thank you!

DISCLAIMER: This channel is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on or linked to from this channel is at the user’s own risk. Please consult your healthcare professional before making any changes in your treatment. I do not respond to requests for medical advice, either as comments/questions on this channel or as direct messages to me.

[JeffreyKnuppelMD]

What's your experience been with benzodiazepines and anxiety? Share your thoughts below! 👇

[natalieturner-zsbd]

I am 88 years young.I have been on alprazolam for 15 years, tried to wean off it did not work, Dr said because of my age I should stay on it, I have anxiety and panic disorders because of family issues. He said it cannot hurt me as being 88 a few more years will not hurt me. I am careful with standing up to fast, but I finally can sleep fine. This may not work for everyone, but each person has a different situation. Sometimes a benzo is necessary. Thanks guys

[SAMEntalhealth]

You are the only freaking person explaining this that well, because I've had panic disorder since I was nine years old, I have Trauma from seeing the first Tower get hit on 9/11, waking up literally 5 minutes after falling asleep hearing that Bang from the tower getting hit, it keeps me up all night sometimes for days, and constant panic, and it's PTSD . On top of that I can't even leave my freaking house, I have severe severe severe panic disorder, I used to throw up before getting on roller coasters, I used to throw up on Christmas day, I still do to this day throw up at times because of nervousness, my doctor today I saw her after waiting 3 months for this appointment, she insists on getting me on an anti-psychotic, I've already been on that one as well and others, along with every single SSRI and snri along with beta blockers which beta blockers actually landed me in the hospital because my brain is so hypersensitive to anxiety that it can tell the difference between low blood pressure and actual Panic anxiety, so she just insisted on going the SSRI route and tell me straight up you don't remember what the effects were when you were on the ssris, I said how are you going to tell me I don't remember if they worked or not. I was like I was on them for extended periods not just a month not just a week, years at a time, and at the same time I don't remember anything? I'm like they don't work for me, I said I'm depressed because I have panic disorder, I can't do anything at the age I am at now, I can't progress the way I want to, I start panicking when I leave the freaking house and I'm not even agoraphobic, my heart just starts to race and I get panicky and I have to go back in the house, but I know that if I had something as a safety blanket in case the Panic started, it could work almost like a placebo where I feel I would not have to actually take them, or as much I mean. I don't want to take them every day, no not at all I understand the pharmacokinetics of benzos, but at the same time to treat every patient the same, insisting they take what they've taken already, and then on top of that I don't know who the genius was that came out and said everybody needs to get off their benzodiazepines right now and these moronic people in this world decided to agree with it and say hey we all need to do this and start suing our doctors, it's like do you guys not remember why you got on them? You're ruining it for the people that actually need them and on top of it, people that are abusing benzos make it harder as well, it's just not fair and this whole world is Twisted I'm glad you posted this because you make a lot of logical sense, I'm at a stand still right now and it's honestly driving me freaking nuts😢

[JamesSwiftakaFifiFrost]

I have severe CPTSD, ocd and agoraphobia. The only drug I have ever taken that help with my panic attacks is xanex. Moved and had to see a new psychiatrist. She instantly took me off of xanex and followed a long trend of treating my anxiety with blood pressure meds. At one point I was on 7 different blood pressure medications. So I started passing out.

[Mintman]

I’ve been on the same benzo for close to 20 years now. One time I ran out and forgot to fill it, it was crazy my mood went from happy to sad, I could not sleep I got 1 hour in 2 days, and I would get really warm then freezing cold. Finally I found out I was without it and went back on it.

[abelperez]

I have suffered with panic disorder for many years, and after being ignored about my illness I was destined to be my own doctor and gave them a chance and lord behold I was able to do things I could never have imagined, I also used it for alcohol withdrawals as I went through a period of depression and anxiety so I turned to alcohol for many years thanks to these meds I feel much happier and free from anxiety depression and alcohol addiction

[stevendavis]

What do you think of 1mg Xanax (as needed ) I do take it everyday . I never am short on meds each month and I’ve been on this dose close to 3 years with no need to up my dose. I’m prescribed bc I’ve had a traumatic experience in 2021 . I got covid and gave it too my mother who passed away from it . Which deep down I blame myself for jt since I gave it too here. This medicine is the only thing that keeps the noise down in my head when I need jt too . Do you think I’m a candidate for long term use.

[Jahzeta]

These meds should not be prescribed for anxiety. MAYBE if severe trauma occured, and then only for a week or 2. You will be worse off after quitting these meds.

[mw]

thankyou for this when used correctly they really do help. What do you say about the doctors that are refusing patients Benzos? Also could you please do a video on anxious patients starting new anti depressants please. It's very scary. I have to start a new one as my old one is making me sick in the stomach 😢

[BrettBustamante]

Here's a good book on this topic: The Maudsley Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs (The Maudsley Prescribing Guidelines Series) 1st Edition.

[Kingboo]

Thank you for the video.
I have refractory GAD and Agoraphobia.
I have been on Diazepam for approximately 6 years, BUT, not daily. PRN only, which usually is 1-2 per week, and sometimes I’ll go for a few weeks without using it.
It is moderately helpful and I tolerate it perfectly.
I think benzodiazepines certainly have their place, but they need to be used appropriately, based on each individuals circumstances.

[stephencaudill]

28 years ago I had anxiety, panic, especially in crowds. I saw a psychiatrist who prescribed clonazepam for 3 months and did exposure therapy to crowded places. As far as Xanax, I know about 30 people who are addicted. The best euphoria is from Valium, imo

[janiceince]

I've had my prescription for years and I've never abused them.. A 30 day perscription would last me like 4 months. Only took half a pill of a low dose when needed.. I realize it's a bandaid and you really need a therapist to get at the root cause of the anxiety and fears and work from there but I'm thankful that I have them for rough times. Like when my mom passed last year and I had to plan everything... There good if you respect them and only take as needed. Dr should prescribe them like my Dr 1 refill for a 6 month period. That's 60 pills for 6 months..That way you don't get addicted to them....I see nothing wrong with that..

[ireneloring]

I have been taking Valium for many years, just the small dose of 2mg and only when needed.I am happy to take these with no high doses, my doctor is reluctant to prescribe them but I tell her at my age what the heck I’m 91

[deborahmoleman]

I have been on cymbalta for around 15years now and it fixed my depression and lessened my anxiety but i still have panic attacks occasionally which are quite horrible, wondering what to do next. My therapist quit and I have a new doctor, not sure i want to see another therapist and tell my story all over again

[kokalti]

Yet I can go and buy as much alcohol as I want (which destroys lives) but doctors wont proscribe me the medication I might need because they care about addiction? Give me a break. This medication should be on a rare as needed bases, not taken every day.

[Flaw-]

Thank you for the video. I was prescribed Prozac and gabapentin and clonazepam as needed. I only take Prozac and clonazepam, I am honestly scared to try gabapentin. My psych doesn't know. My panic disorder is daily and I been trying to find a proper solution without messing my brain any further.

[fivestarservices-euronics]

I would love you’re opinion on my case please. 🙏🏻.
I have had pop a Nic disorder for over 20 years now. I barely drink alcohol nowadays. O can live my normal daily life with no anxiety and my panic and irrational thinking anticipatory anxiety only comes when I have to do something more out of my comfort zone. Such as long travels, shopping centres and Iv completely avoided flying for years so have missed many family holidays down to being too scared of getting in a plane and not being in control at all or able to get back to my safe place if I need too. Iv tried many ssri and currently take 20mg escitalopram which I have recently reduced to 10mg as daily im fine. I was out of comfort zone the other day and freaking out so I had a pint of lager, not recommended I know, but when you get like that u just need an out, and it did I had a great day and my thoughts were not on anxiety at all which was awesome. I was thinking if I had a benzo in these rare occasions or if I were to brave going on a holiday I could take them, fit not daily.

[DonnaH-kcrp]

Diazepam is the worse withdrawal I’ve ever done we don’t prescribe Xanax in the uk 🇬🇧 unless it’s a private prescription

[nickydaviesnsdpharms]

Good video. The one aspect with regards to benzodiazepines which i almost never see content about at least on YouTube, are the relative potencies equivalences between all of the various members of this class. Something i think is important because there are a wide range of potencies between them. For example Chlordiazepoxide (Librium) is approximately 5 times less potent than Diazepam (Valium) which its self is 10 times less potent than Lorazepam (Ativan) which again is it's self, half the potency of Alprazolam (Xanax) Clonazepam (Klonopin) & Triazolam (Halcion)