Even more so than usual, our lives are defined by stress right now, the results of which are a lot of anxious, sleepless nights. For many, this has meant turning to anti-anxiety medications or prescription sleep aids. In the past few months, in fact, prescriptions for anti-anxiety and sleep medications have increased to a point that doctors are growing concerned about the potential for their patients overusing the drugs or developing a dependency on them.
Benzodiazepines such as Klonopin, Xanax, Valium, and Ativan, as well as the sleep aids Ambien and Lunesta, all come with these risks, so before you decide whether to resort to medication, here are a few things you should know.
“The goal is to use these medicines for absolute emergencies, for the short term,” says Asim Shah, M.D., professor and executive vice chair of psychiatry at Baylor College of Medicine.
If you are suffering from debilitating anxiety or insomnia, these medications can offer some much needed but short-term relief.
“These medicines are very efficacious,” Shah says. “They work.”
However, benzodiazepines and prescription sleep aids should not be a first resort, and they are not meant for prolonged use. As with all prescription medications, your first and best resource is your doctor. If you are considering starting on these medications, or are wondering about your current use, talk with your doctor about your questions and concerns.
Benzodiazepines are meant for short-term use only
Benzodiazepines—Ativan, Klonopin, Valium and Xanax—are medications meant for short-term use. This could mean taking them daily for a period of several weeks, then tapering off, or it could be mean taking them infrequently, on an as-needed basis, over a longer period of time.
Examples of this sort of use would include someone who gets a panic attack once or twice a month takes a dose of medicine at the time of the attack or someone developing debilitating anxiety, for which benzodiazepines serve as a short-term fix, until a longer-term, non-habit-forming medication can be prescribed and becomes effective.
Two weeks of benzodiazepines is usually too much
A good indicator that overuse is becoming a problem is if a patient takes these medications daily for more than two weeks without a plan as to how they will taper off on their dosage.
”The problem is when people take it every day, for multiple weeks or months,” Shah says. “These are not meant for [that].”
According to Shah, if you have been taking these medications every day for longer than two weeks, you need a plan for how you will ease off of them. The good news is that if your anxiety is chronic, there are non-habit forming medications, such as Prozac or Lexapro, that can offer a long-term relief.
For these drugs, “their long-term safety profile is better than benzodiazepines,” Shah says. Typically speaking, for chronic anxiety, benzodiazepines are meant as a stop-gap solution, one that will help ease your anxiety until other medications start to have an effect.
Overuse of benzodiazepines can result in drowsiness, confusion, dizziness, blurred vision, lack of coordination and memory loss. Dependence can also result in withdrawal symptoms and even seizures if someone stops taking them abruptly. Withdrawal symptoms are rare for short-term benzodiazepine use, but can become a significant problem with longer-term use.
Prescription sleep aids should be a last resort
Sleep aids such as Lunesta and Ambien should be your last resort to treat chronic insomnia, as they are not meant for long-term use. Generally speaking, they should not be used for longer than a month, and it’s important to stick to the correct dosage.
Before resorting to these drugs, there are a number of other approaches to try first, including working on developing good sleep habits, such as establishing a bedtime routine and avoiding electronics before sleeping. Cognitive behavioral therapy for insomnia, which works on changing sleep habits as well as addressing misconceptions about sleep, can help, too.
If you have tried adjusting your sleep habits without success, the next step would be to try an over-the-counter sleep aid such as melatonin, which has been shown to be safe and non-habit-forming. “Melatonin is a great way because it regulates your normal sleep cycle,” Shah says.
There is also a prescription sleep aid, Rozerem, which is non-habit-forming, and could be a stronger option.
Ambien and Lunesta should not be used for longer than a month
If, after trying all these options, you still need help, Ambien or Lunesta could be beneficial as a short-term sleep aid.
“These are efficacious medicines, and if rightfully used, they help us,” Shah says.
However, Ambien and Lunesta should not be taken for longer than a month, so don’t start taking them without a plan for how you stop. They also come with the risk of side effects, such as sleep-walking, hallucinations and risk of falling—especially for the elderly. Make sure to adhere to the recommended dosage.
If you are at a point where your anxiety or insomnia is having a significant impact on your life, benzodiazepines or prescription sleep aids can offer short-term relief—but you need to be careful how you use them. So talk to your doctor, have a plan and proceed with caution.