Can Benzos Cause Psychosis?

Dr. Ximena Sanchez-Samper

Ximena Sanchez-Samper, MD is a Board- Certified Addiction Psychiatrist who obtained her degree as a psychiatrist at the Mayo Clinic in Rochester, MN and completed her Addictions Fellowship through the combined Massachusetts General Hospital, McLean Hospital / Brigham and Women’s Hospital Addictions Fellowship program in 2004.

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Benzodiazepines and Psychosis

Benzodiazepines are commonly known as benzos, and they are considered a class of highly addictive drugs. When they are prescribed by a doctor, benzodiazepines are typically used for insomnia and anxiety. They are also used as a sedative. 

People sometimes take benzos for recreational purposes because they can cause a calm, relaxed feeling. This is because benzodiazepines decrease nerve activity. Because this class of drugs is highly addictive, benzodiazepines may cause withdrawal effects when someone tries to stop using them. 

How to Recognize a Substance Use Disorder 

If you are dealing with a substance use disorder, you will likely go through a series of different stages. Initially, you may develop a tolerance to benzodiazepines. Tolerance is when you require a higher dose in order to achieve the same effect. Even when you take prescribed medication appropriately, benzos typically lose their efficacy in just four to six months.

After developing a tolerance, you may quickly reach the dependence stage. When people have a dependence on a drug, it means that they need the drug simply to feel normal. A dependence will generally develop sooner if you take a higher dose. 

By this stage, you may be dealing with many of the different symptoms of a substance use disorder. Because benzos are increasingly important to you, you may stop caring about school, work, and family relationships. Your substance use disorder can cause some of the following negative side effects.

  • You continue to use a drug after you realize the harm it is causing you
  • Your appearance, behavior, and physical health may suddenly change
  • Before long, you need more of the drug to feel normal
  • You try and fail to quit
  • When you are using benzos, you do things that you would never do under normal circumstances
  • You have financial problems from spending more money on buying drugs

Once you have developed a substance use disorder, you may experience withdrawal symptoms if you try to stop using benzodiazepines. With benzos, withdrawal symptoms are often protracted. For the first few months, you may suffer from depression, anxiety, and insomnia. In addition, you may develop gastrointestinal, neurologic, and musculoskeletal symptoms. 

Unfortunately, an estimated 2.3 to 18% of Americans have misused tranquilizers or sedatives at some point in their lives. In many cases, people use benzos at the same time as alcohol or other drugs. By mixing different substances at once, people are likely to suffer from additional side effects and drug interactions.

What Is Psychosis?

When individuals experience psychosis, their mental states and perceptions are disrupted. They may struggle to tell what is real or not. Often, people experience hallucinations during psychosis. 

During a psychotic episode, processing information can be challenging, and understanding situations may become impossible for you. Other than hallucinations, you may suffer from delusions and incoherent speech. Likewise, your behavior may be inappropriate for what is going on around you. 

Interestingly, benzodiazepines are frequently used on people who are suffering from psychosis. In particular, benzos help to increase GABAergic function. Because this is typically depressed in people who have schizophrenia, benzos may be able to alleviate the symptoms of schizophrenia-induced psychosis. 

It is also possible for benzos to cause hallucinations. When benzos boost your GABA levels, you may experience a state of relaxation and overall wellness. Unfortunately, these effects tend to disappear when you take higher doses. In large amounts, benzos can cause disturbing delusions and hallucinations.

During the initial stages of substance use, you or a loved one may take benzodiazepines to achieve a state of pleasure or euphoria. Before long, high doses can cause psychosis, paranoia, and violent behavior. Ironically, high doses can cause the same problems that benzos are intended to treat. In large amounts, these drugs can cause anxiety, insomnia, and depression. 

Symptoms of Benzodiazepine Usage

Normally, people take benzos to alleviate insomnia and anxiety. Even when this drug is used as a prescription, it can make you feel dizzy or drowsy. If you take higher doses, these side effects will typically become worse. 

Side effects from abusing this drug can vary depending on the person, the amount they use, and any co-occurring drug use. Over time, benzos can impact someone’s ability to have a relationship or perform well at work. If your loved one suffers from a substance use disorder, you may notice the following symptoms:

  • Coordination issues
  • Coma
  • Breathing problems
  • Confusion 
  • Insomnia 
  • Mood changes 
  • Slurred speech 
  • Anorexia 
  • Weakness 
  • Drowsiness 
  • Anxiety 
  • Headaches
  • Blurred vision

When you take a medication in a higher amount or more frequently than you are supposed to, it can cause severe side effects. With benzos, you may also become dependent on the drug to feel normal. If you stop using this drug, you may develop severe withdrawal symptoms. Because of this, it is important to seek professional help when you try to quit using benzos. 

What Are the Withdrawal Effects Associated With Benzodiazepines?

After you have stopped using benzos, you may suffer from benzodiazepine withdrawal syndrome. This can involve tremors, concentration issues, heart palpitations, tingling, irritability, and sweating. You may become hypersensitive to physical stimuli or feel like things are crawling across your skin.

In some instances, you may develop neurological symptoms as well. For example, you may suffer from paranoid psychotic symptoms. Some people also develop muscle twitching and epilepsy. 

If you use drugs or alcohol at the same time, it can cause additional side effects. It can slow your thoughts and make it difficult to understand what is going on around you. In addition, you may lose your sense of judgment. 

Before long, you may become intoxicated. Instead of simply dealing with delirium, you may suffer from visual distortions and confused thoughts. You may also develop paranoia and hallucinations. 

Can Benzodiazepines Cause Psychosis?

Unfortunately, benzos can trigger psychosis. When individuals don’t follow the directions on their prescription, they increase the chances that they will have side effects. Psychiatrists say that someone is experiencing a psychotic state if they are disconnected from reality. They may talk incoherently or have confused thoughts. 

Often, people who are experiencing psychosis will become agitated. They may hallucinate or feel delusional. To make the situation more challenging, they often do not realize that their behavior is abnormal.

What Happens During a State of Psychosis From Benzos?

If you have developed psychosis from benzodiazepines, you may see or hear things that are not really there. You may feel agitated or anxious. In addition to feeling confused, you may also suffer from drowsiness or mood changes. 

Unfortunately, this state of psychosis may not improve significantly if you stop using benzodiazepines. During the withdrawal stage, you may feel paranoid and delusional. You may also hallucinate. 

How Can You Treat Benzodiazepines Use?

 If you have used benzodiazepines consistently for one to six months, you may develop life-threatening seizures when you quit. Because of this, it is important to seek out professional care when you decide to become sober. Depending on the severity of someone’s drug use and other factors, around 25 to 80% of people will be able to remain sober for at least 12 months. 


One of the first stages in the recovery process is detox. During a detox program, you can receive professional support as you decrease your physical dependence on benzodiazepines. Medical staff members will monitor your withdrawal symptoms, so you will be as safe and comfortable as possible. 

Rehab Options

Detox is merely the first step in the treatment process. Afterward, most people take part in some type of rehabilitation program. They may go to an inpatient or outpatient program. 

Inpatient Treatment

With an inpatient treatment program, you will stay at the treatment center for a specified period. This can be anywhere from a few weeks to a few months. Clients are monitored constantly, so it is impossible to relapse while you are at the rehab center. More importantly, you can get extra support with other mental and physical conditions during the same treatment process. 

Outpatient Treatment

Sometimes, people have outside responsibilities to take care of during rehab. When this happens, they may take part in some kind of outpatient program. This allows them to attend therapy and counseling sessions for part of the day. Afterward, they can return home to their loved ones until the next session. 


After you have finished the treatment process, you can get extra support through aftercare programs. These programs include support groups, private therapy, and self-help meetings. Depending on your unique situation, you may also benefit from sober housing. 


Throughout the recovery process, therapy can provide you with support and guidance. These sessions are available in individual and group settings. In addition, there are different styles of therapy you can choose. 

Cognitive Behavior Therapy (CBT)

CBT helps you to see how your thoughts, feelings, beliefs, and actions are all interconnected. By learning how to change your unhelpful thoughts and feelings, you can spot and avoid high-risk situations. In addition, you can improve your stress management skills. Over time, CBT can help you learn how to prevent a relapse. 

Motivational Enhancement Therapy (MET)

MET can help you understand your inner feelings. Then, you can figure out the advantages and disadvantages of making changes in your life. By helping you improve your internal motivation, MET can catalyze positive changes in your life. 

Contingency Management (CM)

Over time, you need to reinforce your sobriety with positive habits. CM focuses on positive reinforcement and rewards. Through positive reinforcement, this technique can help you complete your treatment program and remain sober. 

Getting Help for Substance Use Disorder 

Dealing with a substance use disorder can be incredibly challenging. Fortunately, you do not have to go through this process alone. At Charles River Recovery, you can get the inpatient program you need to become sober. Through a blend of detox programs and therapy options, this recovery center can help you discover the help you need.