Benzodiazepines are a class of medications commonly used to treat anxiety and related disorders due to their calming and sedative effects. While they can be effective in reducing anxiety symptoms, they are generally not considered a first-line treatment for Obsessive-Compulsive Disorder (OCD), and there are several reasons for this:

• Limited Efficacy: Benzodiazepines are not typically considered as primary treatments for OCD because they do not directly target the core symptoms of OCD, which are obsessions and compulsions. While they may help reduce anxiety and agitation associated with OCD, they do not specifically address the obsessive thoughts or the repetitive compulsive behaviors that characterize the disorder.

• Interference with Exposure and Response Prevention (ERP): ERP is a highly effective form of CBT for OCD that involves exposing individuals to their obsessions and preventing the corresponding compulsions. Benzodiazepines can interfere with the effectiveness of ERP by reducing anxiety and making it more difficult for individuals to confront their fears. In ERP, you are actually using the brain’s amygdala response to reprogram the neural pathways which cause you to do your compulsions. When the brain’s alarm systems are artificially turned off, as they are with benzodiazepines, then the technique is far less effective in reprogramming behavior.

• Risk of Dependence: Benzodiazepines have a high potential for dependence and addiction, especially when used over an extended period. Tolerance can develop quickly, meaning that over time, individuals may need higher and higher doses to achieve the same effect. This can lead to physical and psychological dependence, making it challenging to stop using them.

• Withdrawal Symptoms: Discontinuing benzodiazepines, especially after long-term use, can lead to withdrawal symptoms, which can be uncomfortable and distressing. These symptoms can include anxiety, irritability, insomnia, and even rebound anxiety, which may be worse than the original symptoms. When benzodiazepines are discontinued, obsessions and compulsions will most likely return to the same level.  

• Memory and Cognitive Impairment: Benzodiazepines can cause cognitive and memory impairment, which can be particularly problematic for individuals with OCD who may already experience intrusive thoughts and cognitive difficulties. These drugs can make it harder for individuals to engage in effective cognitive-behavioral therapy (CBT) or other forms of psychological treatment.

Given these factors, healthcare professionals typically reserve benzodiazepines for short-term use, often in acute situations to manage severe anxiety or panic attacks. They are not recommended as a long-term solution for OCD. Instead, the primary treatments for OCD are cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), and, in some cases, medication like selective serotonin reuptake inhibitors (SSRIs). These treatments target the core symptoms of OCD and have a more evidence-based track record for helping individuals manage and reduce their OCD symptoms effectively.

Please contact Kairos Wellness Collective today to learn more about whether CBT or ERP may be the right choice for you.