😴 Benzodiazepines (Anti-Anxiety & Seizure-Rescue Medicines)


What they are:

Benzodiazepines (“benzos”) are fast-acting calming medicines that enhance the effect of GABA, a brain chemical that slows activity and reduces excitement.

In kids, they’re mainly used short-term for:

• Acute anxiety or panic in a medical setting

• Rescue treatment for seizures or status epilepticus

• Certain procedures (MRI, dental work, surgery) to reduce anxiety and muscle tension


Common examples:

• Lorazepam (Ativan)

• Diazepam (Valium; also rectal gel & nasal spray for seizures)

• Midazolam (Versed; often IV or nasal)

• Clonazepam (Klonopin; sometimes for seizures or severe anxiety)


⸻


🧠 How They Work (Simple Version)


Benzos attach to GABA-A receptors in the brain and make GABA’s “calming signal” stronger.

Result: brain cells fire less, leading to reduced anxiety, muscle relaxation, and anticonvulsant effects.


⸻


📊 Use & Safety Facts

• Benzos are very effective for stopping seizures quickly, especially in emergency and pre-hospital settings. Nasal and rectal forms allow caregivers to give rescue medication at home.

• For ongoing anxiety or insomnia, guidelines emphasize short-term use onlybecause the brain can become physically dependent with long-term daily use, especially beyond a few weeks.

• Studies of pediatric prescribing show benzos are used most often in youth with epilepsy, severe anxiety, or other psychiatric conditions, and many long-term prescriptions are not backed by strong child-specific trial data, so careful monitoring is essential.


⸻


😊 When They Help

• Stopping a seizure or cluster of seizures at home or in the ER

• Calming severe panic/anxiety in a hospital setting

• Helping a child safely tolerate a medical procedure


Parents often notice:

• Rapid relaxation

• Sleepiness

• Less shaking, twitching, or seizure activity


⸻


⚠️ Common Side Effects & Risks

• Drowsiness, dizziness, slurred speech

• Poor coordination or confusion

• Memory problems around the time of the dose

• With high doses or in combination with opioids or alcohol, risk of breathing suppression


With regular daily use, the brain can adapt, leading to:

• Tolerance (needing more for the same effect)

• Dependence (withdrawal symptoms if stopped suddenly)


Because of this, experts recommend:

• Lowest effective dose

• Shortest possible duration

• Careful, slow tapering if the medicine has been used regularly for a while


⸻


🌷 What Families Can Do

• Store benzos securely away from other children and teens; they can be misused.

• Use exactly as prescribed — no extra doses without medical guidance.

• For seizure rescue plans, make sure all caregivers (school, babysitters, coaches) know when and how to use the medication.

• If a child has been taking a benzo daily for more than a couple weeks, never stop abruptly; always work with the prescriber on a taper.


⸻


References (Benzodiazepines):

• Edinoff, A. N., et al. (2021). Benzodiazepines: Uses, dangers, and clinical considerations. Neurology International.

• Kienitz, R., et al. (2022). Benzodiazepines in the management of seizures and status epilepticus. Current Opinion in Critical Care.

• Sidorchuk, A., et al. (2018). Benzodiazepine prescribing for children and adolescents. European Journal of Clinical Pharmacology.

• Kaiser Permanente. (2020). Benzodiazepine and Z-drug Safety Guideline.