Longterm Effects of Benzos on the Brain

Added: 2026-05-31

[00:00:00]Could the medication you were given for anxiety or insomnia actually be making you worse? Today, I want to talk about the long-term risks of benzoazipines that many patients are never clearly warned about. We're going to cover three things. Why so many people struggle to get off them, how these drugs can actually make some people worse and more anxious over time, and finally, the cognitive effects including memory problems, mental slowing, accidents, and falls. And for those of you who don't know me, I'm Dr. Ysef. I'm a physician and I'm a former FDA medical officer and also drug safety expert who used to work in the pharmaceutical industry and I make these videos because patients deserve honest information about the risks of these drugs before they even start taking them. And so let's start with the basics first. What are benzoazipines? So these are drugs like Xanax, Clonopin, Adavan and Valium. And while medications like ambient and Sonata are not technically benzo, they work in many similar ways and essentially carry the same risks. All of these drugs increase GABA activity in the brain, which is the main neurotransmitter involved in slowing things down. So, helping with anxiety and things like insomnia. And in the short term, they work really well.

[00:01:05]They're actually quite potent. And this is what makes them so dangerous because they can become addictive very quickly.

[00:01:11]Many people fall into this trap. And it's often not the people you think would get caught up in a trap like this.

[00:01:16]Because what I see in my practice, which really specializes in helping people come off sedative medications like this, is that the people who get caught in this are usually very disciplined, responsible, high functioning adults, business owners, professionals, parents, people who are carrying a lot of responsibilities. These are people who don't think of them as fragile, dependent, or mentally ill or someone who would end up on a psychiatric medication. And usually this is how it happens. You get a major life stressor that hits them. It could be a death in the family, a divorce, a health crisis, or a brutal stretch at work. And typically, sleep starts to fall apart and they try and push through it. They tough it out for weeks, sometimes months, but eventually they get desperate. And and you know this, there's nothing more demoralizing than weeks and weeks of insomnia, especially when you have to get up and perform at a high level. And because they can't function without sleep, they go to a doctor out of desperation and they get prescribed of benzoazipene. And at first it feels like a lifesaver. They sleep again. They're more functional. The crisis passes. But the medication stays and they never really come off it. And over time things begin to shift for them. While the med wasn't causing a lot of problems in the beginning, sometimes after a couple months or sometimes after a few years, people start to feel foggier. They start to feel more tired, more anxious, less sharp. And the drug is no longer working in the way that it used to. It's not holding off those panic attacks. It's not helping as much with the insomnia. They're having more breakthroughs at night. And then that person starts to wonder whether they should come off. And this is when it hits the fan because then they try to do this and this is when they realize they're actually in a much deeper problem than they originally thought because most doctors will taper them down far too quickly or they'll just do it on themselves and they get hit with crushing insomnia, severe anxiety, panic, inner restlessness, brain fog, and they feel like their whole nervous system is on fire. I've had people describe this to me as a complete and total catastrophe. One person even recently told me that it felt like they were being surrounded by a pack of dogs the whole time. And so they go back on the medication and they're fearful about ever coming off again. And what makes this so disturbing is that these often straight lace type A, you know, highly responsible people who barely even drink, they never do drugs or anything like that, they never see themselves as the kind of person who would get stuck in a trap where they're now stuck on a controlled substance. And this can really be a wound to their identity. And typically what they say to me in my practice when I see them is, gosh, I wish someone had told me how hard it can be to get off these medications when I started them because they would have used them for a much shorter period of time. And so let's go into this a little bit. Let's unpack this. Why are these drugs so hard to stop? Well, it's because the brain adapts to them. You see the benzoazipines, they essentially increase the amount of GABA activity in the brain. And over time, the brain adjusts itself to that pressure and it tries to balance itself out. We have to remember that, you know, when we're using psychiatric medications, it's not just pressing on the small circuit that helps you feel calm in your brain. You know, your brain controls everything.

[00:04:17]You know, your heart, your lungs, your digestive tract, all of that. And so, it's constantly getting signals up from those other areas saying, "Hey, you guys slowed things down too much. We need to adapt a little bit so our systems can get back into rhythm." And so what that does is it essentially means that you start to downregulate GABA receptors.

[00:04:35]And so this is what happens now when you try to come off the drug after you're adapted. You actually have even less calming activity than before you started it. Remember because your brain has now adapted to decrease gabber activity to push against the drug. And so that means when people come off these meds, they're dealing with two things at once, which can make them almost impossible to come off for some people. They're dealing a lot of the times with the original problems that got them on the drug. So, if we think about our type A person, you know, they're go go go, you know, maybe they're drinking too much coffee, maybe they're using some stimulants, some nicotine, maybe they're not looking after their health, they're not moving their body, you know, they they've got bad boundaries with their work or maybe even their family. All of the things that you would imagine that would kind of like push someone into a state of like high anxiety, panic, and insomnia.

[00:05:20]So, many people are often still dealing with those things, but on top of that, they're now in a withdrawal state. their brain has less GABA than it did before because they're removing the drug. And it can be so overwhelming when you get that onetwo punch for many of them that even the strongest people can't handle that. And I have seen many adults simply give up on coming off these medications because they don't see a way that they can do this without blowing up their lives. You know, they have jobs, marriages, children, real responsibilities, and so they stay on these drugs for much longer than they ever intended. Now, another thing that I think is really important to mention now when it comes to withdrawal is that it's very important to come off these drugs in a very gradual and safe way because one risk that almost all doctors don't tell their patients about with benzoazipines is the risk of something called a protracted withdrawal injury.

[00:06:11]It's a type of neurological damage that happens when people come off the medications too quickly. And this may be surprising because most people think, hey, if I come off the medication and I can't stand the withdrawal, you know, I'll just white knuckle it for a while and after a few months, if that doesn't work out for me, I'm just going to get back on the drug and it's going to go away. For a small group of people, that doesn't happen. And that's because the actual act of coming off the medication too quickly is damaging to the nervous system. And if you look at the guidelines from the American Society of Addiction Medicine, they say that tapering too quickly is thought to be associated with developing this protracted withdrawal injury. And what I have seen in my clinical practice and what many of my colleagues who work in this space have seen is that that is very likely true because that's typically how it plays out. And this side effect can be so devastating that it has been covered in multiple national media stories over the last couple of years. And it has even been added to the side effect labels of all benzoazipines in the United States. And so let's talk a little bit about what this looks like.

[00:07:12]So if you come off one of these medications and you develop one of these protracted withdrawal injuries, many people will experience symptoms like, you know, sound sensitivity, ringing in their ears, light sensitivity, severe anxiety where they're constantly in a state of panic, brain fog, you know, stomach problems as well, sometimes tingling in their hands and feet, their face and neck, and also like a racing heart that comes out of nowhere. And sadly in my practice what I have seen is that after this happens it can take sometimes up to 2 years and sometimes even longer for this to go away. Now the second problem with these medication which again doesn't happen to everyone but there's a small group of people who are susceptible to this is an issue called benzoazipene induced neurological dysfunction. Again this is a newer side effect that has been recognized over the last 5 years or so.

[00:08:01]It's been covered in several medical journals recently. And this is essentially a type of neurotoxicity where you take the drug and in a group of people, you know, who are vulnerable to it and we cannot predict that the drug actually starts to make them worse.

[00:08:16]And usually what I see is that this happens after several years. But I have seen this occur after about 6 months or so. And what people will find is that they gradually start to feel worse on the drug. They'll start to have muscle tightness, sometimes tremors. They start to have mood swings. They feel more irritable. They feel more anxious. And they have brain fog. And it gets worse and worse. Now, typically what someone will do when they're feeling worse is they'll say, "Well, let's just up the drug. Maybe maybe I'm in withdrawal or something like that." And so, they increase the dose. And what they find is that it often makes them worse. And the reason it makes them worse is that the drug has now turned on them and it's actually causing these symptoms. Now, if the person is lucky enough to realize that their symptoms are actually coming from the drug and they start to come off, that's the right thing to do. That is the quickest pathway to actually getting better from this. But sadly, many people don't recognize this. They go back to the psychiatrist. The psychiatrist diagnoses them with a new condition and then they get put on multiple new different types of medications, all of which they generally respond to in a negative way. Because once you have destabilized the nervous system because you're having one of these bad reactions to a medication, what I see in my practice is that people do not respond to medications in a predictable way. And so that's something to be avoided. Now, one of the biggest challenges about getting off benzoazipines once you've developed bind and they're making you feel worse is that the people are generally very sensitive to any reductions because their nervous system is already hurt from the medication and they actually feel withdrawal symptoms even more. And in order to get off the drugs, you have to do it in a very gradual way. And if you want more information on how to do this safely, if you look below this video, I've put together a free drug tapering guide. It's what I've learned by doing this with hundreds of patients over the last nearly 6 years. And it has essentially the technique that I would recommend for most people and coming off these medications in a very gentle way.

[00:10:10]Now, the next risk is about cognitive side effects. And this matters a lot.

[00:10:14]You know, remember as I said, like most of the people who get stuck on benzo are these typea high functioning adults who usually have pretty demanding jobs. And one of the crulest things about long-term benzo use is that the cognitive effects creep up on people over time. Often times, no one else realizes this except the person going through them because on the outside they still look good. They may be going to work, paying bills, still showing up, but inside they're feeling different.

[00:10:38]They feel less sharp. They feel slower.

[00:10:41]They feel more mentally tired, less able to focus, less able to juggle complex things. And for someone who's built a life on being capable, this can be terrifying. And we actually have some pretty good data that quantifies how much of a cognitive hit many of these patients take. And so this one study here looked at 92 long-term benzodizopene users, and it gave them a battery of neurosychological tests. And the researchers found broad cognitive impairment across the groups with the biggest deficits being in processing speed and sustained attention. So sustained attention fairly self-explanatory. Processing speed is how long it takes you to think through complex things. And here's what they found in more detail. About one in five met criteria for overall cognitive impairment. This meant that they were one standard deviation below their control group across all areas of cognitive functioning. And the most affected areas were again you know processing speed, sustained attention.

[00:11:34]But the other areas were also executive function and episodic memory. And what is striking as well is that these deficits were not clearly explained by age or dose. Meaning you could be quite young and also on a fairly low dose but still be very susceptible to these effects. So how do these symptoms turn up in real life for benzoazipene users?

[00:11:52]Well, typically what my patients say to me is that they feel like it takes them longer to think through things. They struggle to stay focused in meetings or during deep work. They find they need much more effort just to do things that would come to them naturally and just overall they feel like their brain is not operating at the old level of functioning. And so what do you do if you're in a situation like this where you're worried about the dependency on the medications, the fact that they may actually make you worse, more anxious, all of that, and also the cognitive problems. Well, what I have to tell you to do is do not stop these drugs suddenly. We already talked about protracted withdrawal. You need to come off them in a careful way to protect your nervous system, but on top of that, you need to come off them in a way where you can remain functional and you can keep on working and doing all of the things that are important to you. And so, what you need is a careful, competent plan off these medications because there is a way to get off these medications safely. You know, the first step will be to check out that guide that I mentioned just a moment ago. But if you'd actually just like a team to hold your hand and walk you through the whole thing so you can keep your life together as you come off this, you may be interested in our medical practice.

[00:12:55]We work in the United States. Our website is www.tapercl clinic.com.

[00:12:59]There's also going to be a link to that below and you can check us out to see if we're a good fit for you. Now, one thing that surprises a lot of people is just how common these effects are. These aren't things that are just happening in the dark. And so if you want to see a real world example of a well-known person who went through something like this, you're not going to want to miss this next video where I break down how benzipines affected Jordan Peterson in a severe Okay.