Benzodiazepines such as alprazolam (Xanax), clonazepam (Klonopin) and lorazepam (Ativan) calm anxiety within minutes. That speed is why they are so widely used, and why daily long-term use causes problems.
The risks of long-term daily use
- Tolerance and dependence: the same dose works less well over time, and the body comes to rely on it.
- Memory, focus and balance problems, with a higher risk of falls and car crashes, especially in older adults.
- Dangerous combinations: with alcohol, opioids or other sedatives, breathing can slow to a dangerous level.
- Rebound anxiety between doses, especially with short-acting alprazolam.
In 2020 the FDA added a boxed warning to all benzodiazepines about misuse, dependence and withdrawal reactions.
Where they still fit
Short-term use during a crisis, or while a daily treatment such as an SSRI takes effect, and specific situations such as some procedures.
Already taking one daily?
Do not stop suddenly. Abrupt discontinuation after regular use can cause severe anxiety, insomnia and, rarely, seizures. A slow, supervised taper over weeks to months, alongside therapy and a long-term treatment, is the safe path.
Long-term alternatives
SSRIs and SNRIs, buspirone, cognitive behavioral therapy and, for sleep, CBT for insomnia. Read the next steps when anxiety treatment is not working.
Get help from Hope Integrative Medicine
If you rely on a benzodiazepine and want a safer long-term plan, we can build one with you. Our mental health team sees patients in person in West Ashley and by telehealth across South Carolina, and new patients are often able to be scheduled within a week of requesting an appointment. Request an appointment.
This article is general health information and does not replace advice from your own provider. Never start, stop or change a medication without talking with your prescriber. If you are having thoughts of harming yourself, call or text 988 or call 911.
Frequently Asked Questions
Daily long-term use of Xanax and other benzodiazepines leads to tolerance and dependence and raises the risk of memory problems, falls and dangerous interactions. They are best used short term.
No. After regular use, stopping suddenly can cause severe anxiety, insomnia and, rarely, seizures. Taper slowly with your prescriber.
Long-term options include SSRIs and SNRIs, buspirone and cognitive behavioral therapy. Hydroxyzine is a non-habit-forming option for occasional use.