Benzodiazepines/Tranquilisers

Our rating
For adults 1 smiley: This treatment is promising and may be useful. It has some evidence to support it, but more evidence is needed to be sure it works.
For children and the elderly Question mark: This treatment has not been properly researched. It is not possible to say whether they are useful or not.

What is it?

Benzodiazepines are a class of medicines which are usually used to treat anxiety and insomnia. They are sometimes also called tranquilisers. Benzodiazepines are sometimes prescribed on their own as a treatment for depression, or they can be prescribed in conjunction with an antidepressant medication– this is known as combination therapy. Examples of common benzodiazepines are:

  • diazepam (sold under the brands Valium, Ducene, Antenex and Propam)
  • alprazolam (sold under the brands Xanax and Kalma)
  • oxazepam (sold under the brands Serepax, Murelax, Alepam and Benzotran)
  • lorazepam (sold under the brand Ativan)

How does it work?

Benzodiazepines work by increasing the efficiency of GABA, a neurotransmitter (chemical messenger) in the brain. GABA inhibits the activity of cells in the brain, so benzodiazepines have an overall “slowing down” effect on the brain. This can relive anxiety, which is often experienced by people who have depression. However, these drugs do not increase the supply of the neurotransmitters serotonin and noradrenaline which are believed to be in short supply in depression.

Is it effective?

There is some scientific evidence on benzodiazepines for the treatment of depression. A review of 21 studies found that, when used on their own, benzodiazepines are more effective than a placebo (dummy pill) and are about as effective as some types of antidepressants. Only one type of drug, alprazolam, was looked at in this review.

A systematic review found that patients were more likely to show improvements in their mood on combination therapy (using both benzodiazepines and antidepressants) compared to taking antidepressants alone, but only in the short term.

Benzodiazepines have not been compared to newer antidepressant medications, which may be more effective. It is also possible that some people show improvement when taking benzodiazepines because they have problems with anxiety along with depression. People who do not experience any anxiety may not find benzodiazepines helpful.  

There is no evidence which has looked at the effects of benzodiazepines for the treatment of minor or sub-clinical depression. There is also no evidence looking at the use of benzodiazepines with adolescents and children.

Are there any disadvantages?

Benzodiazepines can be addictive and patients may become dependent on them. This can cause withdrawal symptoms when the medication is stopped. This can be a serious disadvantage and should be considered when deciding whether or not to take benzodiazepines. There are a number of side effects associated with benzodiazepine use, including drowsiness, dry mouth, constipation, dizziness, and blurred vision, amongst others. Benzodiazepine use can also cause an increase in accident proneness, which may lead to injuries.

Where do you get it?

Benzodiazepines are available with a prescription from your doctor.

Recommendation

Benzodiazepines may be helpful for depression, but they do have disadvantages and are not recommended as a stand alone treatment for depression. If you are interested in using benzodiazepines you should speak to your doctor, who can recommend if this treatment is right for you.

Key references

  • Furukawa TA, Streiner D, Young LT, Kinoshita Y. Antidepressants plus benzodiazepines for major depression. Cochrane Database Syst Rev. 2001; 3.
  • Barbui C, Cipriani A, Patel V, Ayuso-Mateos JL, van Ommeren M. Efficacy of antidepressants and benzodiazepines in minor depression: systematic review and meta-analysis. Br J Psychiatry. 2011; 198(1):11-6, sup 1.
  • van Marwijk H, Allick G, Wegman F, Bax A, Riphagen II. Alprazolam for depression. Cochrane Database Syst Rev. 2012; 7. 

Last reviewed and updated: 1 December 2016