Yes, benzodiazepines can cause seizures, and the risk is serious enough that the FDA requires a boxed warning about it on every benzodiazepine medication. The most common way this happens is through withdrawal: stopping the drug too quickly or abruptly after your body has become physically dependent on it. In rare cases, benzodiazepines can also paradoxically worsen seizures in people who already have certain types of epilepsy.
How Withdrawal Triggers Seizures
Benzodiazepines work by enhancing the activity of GABA, your brain’s main calming chemical. When you take them regularly, even for just several days to weeks, your brain adapts. It produces less GABA, reduces the number and sensitivity of GABA receptors, and ramps up excitatory signaling to compensate for the constant sedation. This is physical dependence, and it can develop even when you take the medication exactly as prescribed.
When the drug is suddenly removed, your brain is left in a hyperexcitable state. The calming system has been dialed down, and the excitatory system, particularly receptors that respond to glutamate (the brain’s primary excitatory chemical), has been dialed up. More calcium floods into nerve cells, making them fire more easily. The result can range from anxiety and insomnia to full seizures. This rebound hyperexcitability is essentially the mirror image of what the drug was doing: the brain overshoots in the opposite direction.
Short-Acting vs. Long-Acting Medications
Not all benzodiazepines carry the same seizure risk during withdrawal. Short-acting formulations like alprazolam (Xanax) are significantly more dangerous to stop abruptly than long-acting ones like diazepam (Valium). The reason is straightforward: a short-acting drug leaves your system quickly, giving your brain less time to adjust. A long-acting drug tapers itself to some degree because it lingers in your body for days.
The U.S. Department of Veterans Affairs specifically warns that withdrawal seizures are more likely with alprazolam than with other benzodiazepines, and that rapidly tapering alprazolam or abruptly switching to a different benzodiazepine is not recommended because of this risk. Withdrawal symptoms from short-acting drugs also tend to be more intense, though they may resolve faster than withdrawal from longer-acting medications.
The FDA’s Boxed Warning
The FDA’s updated boxed warning, its most prominent safety label, states plainly: “Stopping benzodiazepines abruptly or reducing the dosage too quickly can result in serious withdrawal reactions, including seizures, which can be life-threatening.” This warning applies to every benzodiazepine on the market, regardless of the specific drug or the reason it was prescribed. The agency also notes that physical dependence can develop after steady use for as little as several days to weeks.
How Tapering Reduces the Risk
The primary way to prevent withdrawal seizures is a gradual, supervised taper rather than stopping cold turkey. A 2025 clinical practice guideline published in the Journal of General Internal Medicine recommends starting with dose reductions of 5 to 10% and limiting the pace to no more than 25% every two weeks. After the initial reduction, further cuts of 5 to 10% every six to eight weeks (or slower) are recommended based on how you respond.
People who have been taking a lower dose for less than about three months may tolerate slightly faster reductions in the range of 10 to 25%. But for anyone on higher doses or longer-term use, the process is deliberately slow, sometimes stretching over many months. The goal is to give your brain time to restore its own calming chemistry without overshooting into dangerous excitability.
If you’ve been taking a benzodiazepine regularly and want to stop, the critical point is to never quit abruptly on your own. Even if you feel fine for the first day or two, seizures can occur as drug levels drop, and the timing depends on which benzodiazepine you’re taking.
Can Benzodiazepines Cause Seizures While You’re Taking Them?
This is rarer, but it does happen. Benzodiazepines are actually first-line treatments for acute seizures and status epilepticus, so the idea that they could worsen seizures sounds contradictory. But a phenomenon called paradoxical seizure aggravation has been documented, particularly with a specific type of epilepsy: sleep-activated frontal lobe seizures.
In one reported case, a 23-year-old man with frontal lobe epilepsy was given intravenous diazepam to treat a cluster of nighttime seizures. Instead of improving, his seizures accelerated to one every three to five minutes. The more benzodiazepines he received, the worse the seizures became. It wasn’t until several hours after the last dose that the seizure frequency began to drop, and they eventually stopped the following morning. In a second case, a 20-year-old man with similar sleep-activated frontal lobe seizures saw his seizure frequency triple after a benzodiazepine was added to his regimen. When it was stopped and replaced with a different medication, his seizures dropped back to baseline.
The suspected mechanism is that benzodiazepines promote sleep and sedation, which can provoke seizures in people whose seizures are specifically triggered by sleep. This is a narrow scenario, not a general risk for most people taking benzodiazepines. But it underscores that these medications, while powerful anti-seizure tools in most contexts, are not universally safe for every seizure type.
Who Faces the Highest Risk
Several factors increase the likelihood of withdrawal seizures. Taking a high dose, using a short-acting benzodiazepine, and longer duration of use all raise the stakes. People who have experienced seizures before, whether from benzodiazepine withdrawal or other causes, are at higher risk during subsequent withdrawals. Using alcohol or other sedatives alongside benzodiazepines compounds the danger because alcohol withdrawal involves the same GABA pathways and can create overlapping hyperexcitability.
Abrupt discontinuation is the single biggest risk factor. This includes situations where someone runs out of their prescription unexpectedly, is hospitalized and their home medications aren’t continued, or decides to stop on their own without a taper plan. In all of these scenarios, the sudden drop in drug levels can push a dependent brain past the seizure threshold within hours to days.