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[Pharmacology](https://durgical.com/en/pharmacology/) · Class

# Benzodiazepines

Calming medicines that strengthen the brain's main brake, GABA. They treat anxiety, seizures and alcohol withdrawal, and sedate before procedures.

Updated 2026-11-01

## What they are

Anxiolytic, sedative, hypnotic, anticonvulsant and muscle-relaxant medicines built on a benzodiazepine ring. They differ mainly in speed of onset, duration and active metabolites: midazolam is short acting and used for procedures, lorazepam and diazepam for seizures and alcohol withdrawal, alprazolam and clonazepam for panic disorder.

## Mechanism of action

They bind the benzodiazepine site of the GABA-A receptor, between the α and γ subunits, and are positive allosteric modulators: GABA binds more readily and the chloride channel opens more often. More chloride enters the neuron, which becomes harder to excite. Flumazenil competitively blocks this site.

Target: GABA-A receptor (benzodiazepine site)

## Key points

- Boxed warning: with opioids they can cause profound sedation, respiratory depression, coma and death.
- They increase the frequency of chloride channel opening (barbiturates increase its duration).
- Stopping suddenly after regular use can cause a dangerous withdrawal with seizures; they are tapered.
- Lorazepam, oxazepam and temazepam are cleared by glucuronidation without active metabolites, which suits older adults and liver disease.
- Flumazenil reverses them, but can trigger seizures in people dependent on benzodiazepines.

## Drugs in this class

- [**Diazepam** A long-acting benzodiazepine for anxiety, alcohol withdrawal, muscle spasm and seizures. It and its active metabolites… GABA-A receptor, benzodiazepine site](https://durgical.com/en/pharmacology/diazepam/)
- [**Lorazepam** An intermediate-acting benzodiazepine, first choice for stopping status epilepticus. It has no active metabolites… GABA-A receptor, benzodiazepine site](https://durgical.com/en/pharmacology/lorazepam/)
- [**Midazolam** A short-acting benzodiazepine for sedation in procedures and intensive care. Given IV it can stop breathing, so it… GABA-A receptor, benzodiazepine site](https://durgical.com/en/pharmacology/midazolam/)
- [**Alprazolam** A triazolobenzodiazepine used for panic disorder and anxiety. Anxiety between doses, dependence and withdrawal are… GABA-A receptor, benzodiazepine site](https://durgical.com/en/pharmacology/alprazolam/)
- [**Clonazepam** A long-acting benzodiazepine used for some seizure types and for panic disorder. Tolerance to its antiseizure effect… GABA-A receptor, benzodiazepine site](https://durgical.com/en/pharmacology/clonazepam/)
- [**Chlordiazepoxide** A long-acting, self-tapering benzodiazepine (active metabolites) used for anxiety and to prevent the dangers of… GABA-A receptor, benzodiazepine site](https://durgical.com/en/pharmacology/chlordiazepoxide/)
- [**Oxazepam** A short-to-intermediate benzodiazepine with no active metabolites, used for anxiety and alcohol withdrawal, often when… GABA-A receptor, benzodiazepine site](https://durgical.com/en/pharmacology/oxazepam/)
- [**Temazepam** A benzodiazepine used for a short time to treat insomnia. It has no active metabolites; like other hypnotics it can… GABA-A receptor, benzodiazepine site](https://durgical.com/en/pharmacology/temazepam/)
- [**Triazolam** A very short-acting benzodiazepine for brief treatment of insomnia. It can cause next-day memory gaps and interacts… GABA-A receptor, benzodiazepine site](https://durgical.com/en/pharmacology/triazolam/)

## Others in the class

- Clobazam
- Bromazepam
- Clorazepate
- Remimazolam

## Test yourself

Think of the answer, then tap the question to see it.

## How do benzodiazepines change the GABA-A chloride channel?

They make it open more often in the presence of GABA; they do not open it on their own.

## Which combination carries a boxed warning for death from respiratory depression?

Benzodiazepines with opioids.

## Which three benzodiazepines have no active metabolites (glucuronidation only)?

Lorazepam, oxazepam and temazepam.

## Why can flumazenil be dangerous in a long-term benzodiazepine user?

It can precipitate sudden withdrawal, including seizures.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - DIAZEPAM tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c397a9da-862f-4f3f-8109-7d21691de53a) (DailyMed (U.S. National Library of Medicine), 2026); [DailyMed - LORAZEPAM tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1bf22e97-9425-484d-bac6-519c6bae6a37) (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 22 (McGraw Hill, 2023); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N05BA) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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