Benzodiazepines in Anxiety: A Literature Review on Therapeutic Effects and Risks

Abstract

Introduction: Benzodiazepines are widely prescribed drugs for anxiety disorders due to their anxiolytic, hypnotic, and anticonvulsant effects; however, their long-term use involves clinically relevant risks. Objective: To analyze the role of benzodiazepines in the treatment of anxiety disorders, considering their clinical efficacy and associated adverse effects. Materials and Methods: A bibliographic review was conducted of the literature published between 2019 and 2024 in PubMed, Scopus, and Cochrane Library. A total of 42 scientific articles were identified, including 25 systematic reviews or meta-analyses, 10 clinical trials, and 7 observational studies, prioritizing those with high methodological quality and clinical relevance. Results: Benzodiazepines showed efficacy in the rapid relief of acute anxiety symptoms (90% of the studies) and in the management of insomnia and seizure disorders. However, chronic use was associated with dependence in up to 60% of reported cases, progressive cognitive impairment, and increased risk of falls among older adults, especially in the presence of polypharmacy. Conclusions: Rational, short-term, and medically supervised use—combined with non-pharmacological interventions such as cognitive-behavioral therapy—is essential to optimize the safety and effectiveness of benzodiazepines in contemporary clinical practice.