Skip to content

Side Effects of Benzos and Z-Drugs

side effects

Benzodiazepine and Z-drug adverse reactions are many, diverse and range from mild to catastrophic, even life-threatening.   See the tables below for alphabetical listings of adverse reactions.  Benzodiazepine users are at a significantly increased risk of mortality.  Of the many studies that have been done on this, perhaps the most significant was done in 2012 by Kripke, Langer & Kline.[7]  This 2.5-year study showed that frequent BZ users (>132 doses per year) were 5.3 times more likely to die than those who did not use BZs.  Even with 18 or fewer doses per year, BZ users were 3.6 times more likely to die.

Adverse reactions include psychologic, neurophysiologic, and somatic reactions which may challenge patients and clinicians trying to determine if symptoms are due to these agents, or something else. At times the relationship can only be determined retrospectively after discontinuation. Because of the latter, it is important to consider deprescribing, particularly if other potential causes are eliminated.

Table 4:  Benzodiazepine Side Effects (alphabetical)
  1. Abdominal distress
  2. Addiction
  3. Aggressiveness / Violence
  4. Agranulocytosis
  5. Akathisia / Agitation
  6. Allergic reaction
  7. Alexithymia
  8. Altered level of consciousness
  9. Anaphylaxis
  10. Anemia
  11. Anhedonia
  12. Anxiety
  13. Anorexia
  14. Anterograde amnesia
  15. Arthralgia
  16. Balance problems / Ataxia
  17. Bizarre behavior
  18. Cancer
  19. Chills
  20. Coma
  21. Constipation
  22. Coordination ↓
  23. Death
  24. Delusions
  25. Dementia
  26. Depersonalization
  27. Depression
  28. Derealization
  29. Diarrhea
  30. Disinhibition
  1. Disorientation
  2. Dizziness / Lightheadedness
  3. Dreams vivid
  4. Driving problems / Motor vehicle accidents
  5. Dyscognition
  6. Edema
  7. Emotional lability
  8. Encopresis
  9. Enuresis
  10. Eosinophilia
  11. Erectile dysfunction
  12. Euphoria
  13. Excitement
  14. Extrapyramidal symptoms
  15. Falls
  16. Fatigue / Malaise / Lethargy
  17. Fear
  18. Fractures
  19. Gastritis
  20. Gums sore
  21. Hair loss
  22. Hallucinations
  23. Hangover effects
  24. Headache
  25. Heartburn
  26. Hemiparesis
  27. Hepatic encephalopathy precipitated
  28. Hepatic toxicity / Jaundice
  29. Hirsutism
  30. Homicidal ideation / Attempts / Completed
  1. Hyperactivity
  2. Hyperventilation
  3. Hyponatremia
  4. Hypotension
  5. Hypothermia
  6. Hypoventilation / Apnea
  7. Impulsivity
  8. Infection
  9. Injury
  10. Irritability
  11. Insomnia
  12. Leukopenia
  13. Lymphadenopathy
  14. Mania
  15. Menstrual disturbance
  16. Movement abnormalities
  17. Muscular rigidity / cramps / dystonia
  18. Myasthenia / Hypotonia
  19. Nasal congestion
  20. Nausea, Vomiting
  21. Neonatal Withdrawal Syndrome
  22. Nightmares
  23. Nystagmus
  24. Overdose / Overdose death
  25. Pain
  26. Pancytopenia
  27. Paresthesia
  28. Physiological dependence
  29. Pruritus
  30. Psychosis
  1. Rash – various types
  2. Reflexes ↓
  3. Rage
  4. Respiration suppressed
  5. Salivation ↓  or  ↑
  6. Sedation
  7. Seizure ↑
  8. Sexual dysfunction
  9. Syndrome of Inappropriate Antidiuretic Hormone
  10. Sleep architecture disrupted
  11. Sleep behavior disturbance
  12. Smell disturbance
  13. Somnolence / Drowsiness
  14. Stomatitis
  15. Stupor
  16. Suicidal ideation / Attempts / Completion
  17. Sweating
  18. Syncope
  19. Tachycardia / Palpitations
  20. Talkativeness
  21. Taste disturbance
  22. Thrombocytopenia
  23. Urinary incontinence
  24. Urinary retention
  25. Vaginal discharge, itching
  26. Vasomotor disturbances
  27. Vertigo
  28. Visual disturbance
  29. Warm feeling
  30. Weight ↓ or  ↑
  31. Withdrawal symptoms
  32. Xerostomia
Table 5:  Z-Drug Side Effects (alphabetical)
  1. Acne
  2. Addiction
  3. Aggressiveness
  4. Agitation
  5. Albuminuria
  6. Allergic reaction
  7. Altered level of consciousness
  8. Anemia
  9. Angioedema
  10. Anterograde amnesia
  11. Anxiety
  12. Apathy
  13. Appetite ↓  or  ↑
  14. Arthralgia
  15. Arthritis
  16. Asthma
  17. Back pain
  18. Balance problems
  19. Bizarre behavior
  20. Blepharitis
  21. Breast cancer
  22. Breas enlargement
  23. Bruxism
  24. Bundle branch block
  25. Bursitis
  26. Cataract
  27. Cellulitis
  28. Cerebrovascular disorder
  29. Chelitis
  30. Chest pain
  31. Chills
  32. Cholelithiasis
  33. CNS stimulation
  34. Colitis
  35. Coma
  36. Confusion
  37. Conjunctivitis
  38. Constipation
  39. Coordination ↓
  40. Corneal erosion
  41. Cough / Bronchitis
  42. Death
  43. Dehydration
  44. Delusions
  45. Depersonalization
  46. Depression worse
  47. Diabetes mellitus
  48. Diarrhea
  49. Disinhibition
  50. Dizziness / Lightheadedness
  1. Driving problems / MVAs
  2. Duodenal ulcer
  3. Dreams vivid
  4. Drugged feeling
  5. Dyscognition
  6. Dysrhythmia
  7. Dyspepsia
  8. Dyspnea
  9. Dystonia
  10. Edema
  11. Emotional lability
  12. Enteritis
  13. Epistaxis
  14. Eructation
  15. Esophagitis
  16. Euphoria
  17. Eye pain
  18. Eye watering
  19. Facial paralysis
  20. Fatigue / Malaise / Lethargy
  21. Fever
  22. Flatulence
  23. Flu-like symptoms
  24. Fracture
  25. Gastritis
  26. Gastroenteritis
  27. GI bleed
  28. Gingivitis
  29. Glaucoma
  30. Glossitis
  31. Goiter
  32. Gout
  33. Gynecomastia
  34. Hangover effects
  35. Halitosis
  36. Hematuria
  37. Hepatic encephalopathy precipitated
  38. Hepatic: hepatocellular, cholestatic
  39. Hepatomegaly
  40. Hiccups
  41. Hostility
  42. Hot flashes
  43. Hallucinations
  44. Headache
  45. Hypercholesterolemia
  46. Hyperesthesia
  47. Hyperglycemia
  48. Hypertension
  49. Hypertonia
  50. Hyperventilation
  1. Hypoesthesia
  2. Hypoglycemia
  3. Hypokalemia
  4. Hypokinesia
  5. Hypotension / Postural hypotension
  6. Hypothyroidism
  7. Hysteria
  8. Injury
  9. Insomnia
  10. Intestinal obstruction
  11. Ketosis
  12. Lactose intolerance
  13. Laryngitis
  14. Leukorrhea
  15. Lymphadenopathy
  16. Mania
  17. Mastitis
  18. Memory impairment
  19. Menstrual disorder
  20. Migraine
  21. Muscle cramps / spasm / trismus
  22. Muscle twitching
  23. Myasthenia
  24. Myoclonus
  25. Myopathy
  26. Neck rigidity
  27. Neonatal effects
  28. Neuralgia / Neuritis / Neuropathy
  29. Neurosis
  30. Nausea / Vomiting
  31. Nystagmus
  32. Oliguria
  33. Osteoporosis
  34. Otalgia
  35. Otitis media / externa
  36. Overdose
  37. Pain
  38. Pallor
  39. Palpitations
  40. Panic attacks
  41. Paresthesia
  42. Personality changes / disorder
  43. Photosensitivity
  44. Physiological dependence
  45. Pleural effusion
  46. Pruritus
  47. Psychomotor impairment
  48. Psychomotor retardation
  49. Ptosis
  50. Purpura
  1. Rash: various types
  2. Reflexes ↓ or  ↑
  3. Respiratory depression / apnea
  4. Respiratory infection
  5. Restless legs
  6. Rigors
  7. Salivation ↑
  8. Sedimentation rate ↑
  9. Sexual dysfunction
  10. Skin discoloration / melanosis
  11. Sleep behavior problems
  12. Sleep disorder
  13. Smell disturbance
  14. Snoring
  15. Somnolence
  16. Speech disorder / slurred
  17. Stomach ulcer
  18. Stomatitis / mouth ulceration
  19. Strange feelings
  20. Suicide Ideation, completion
  21. Sweating
  22. Syncope
  23. Tenosynovitis
  24. Taste disturbance
  25. Thirst
  26. Thrombophlebitis
  27. Tinnitus
  28. Tongue discoloration
  29. Tremor
  30. Upper respiratory infection
  31. Urethritis
  32. Urinary frequency
  33. Urinary incontinence
  34. Urinary tract infection
  35. Urinary urgency
  36. Urolithiasis
  37. Urticaria
  38. Vaginal hemorrhage
  39. Vaginitis
  40. Vertigo / labyrinthitis
  41. Viral infections
  42. Visual disturbance
  43. Weight gain / loss
  44. Withdrawal symptoms
  45. Xeroderma
  46. Xerophthalmia
  47. Xerostomia