Practice Policy: Prescribing of Hypnotics and Anxiolytics

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At our GP practice, our priority is always the long-term health, safety, and well-being of our patients. In line with current UK national clinical guidelines (including NICE) and growing medical evidence regarding patient safety, this practice does not routinely issue new prescriptions, or support long-term use of, specific medications for insomnia, anxiety, or agitation.

Specifically, this policy applies to:

• Z-drugs (for sleep): Zopiclone and Zolpidem
• Benzodiazepines (for sleep, anxiety, or agitation): Diazepam, Lorazepam, Nitrazepam, Temazepam, and Chlordiazepoxide

We understand that sleep issues, severe anxiety, and agitation are incredibly distressing. However, medical evidence shows that these medications are not a safe or effective long-term solution.

Why we have adopted this policy

While these medications can be useful for short-term, acute crises (lasting no more than a few days to two weeks), regular or long-term use poses significant health risks:

• Tolerance and Effectiveness: These medications quickly lose their effectiveness. Within just a few weeks of regular use, the body adapts, and they no longer work as well as they did initially.
• Physical and Psychological Dependence: They are highly addictive. Patients frequently experience severe "rebound" symptoms—such as worsened insomnia or heightened anxiety—when they try to stop.
• Increased Health Risks: Long-term use is strongly linked to cognitive impairment, memory problems, daytime drowsiness, and a significantly increased risk of falls and fractures (particularly in older adults).
• Accidental Overdose: When combined with alcohol or certain other medications (like strong painkillers), they can cause dangerous respiratory depression.

What this means for our patients

1. New Requests

Our clinical team will not issue new prescriptions for Zopiclone, Zolpidem, or Benzodiazepines for ongoing sleep issues, anxiety, or agitation long term. Instead, we will work with you to explore safer, evidence-based alternatives and if on these medication we will aim to wean you off. We do not recommend it for even for short term usage. 

2. Existing or Repeat Prescriptions

If you are currently taking one of these medications on a regular or repeat basis, please do not stop taking it suddenly, as this can cause dangerous withdrawal symptoms.

Our clinical team will work with you supportively to review your medication. Our goal will be to create a gradual, safe, and managed reduction plan (a taper) to help you safely come off the medication at a pace your body can tolerate, while introducing alternative coping strategies.

Safer Alternatives and Support

We are fully committed to helping you manage sleep and anxiety effectively. Depending on your specific needs, we can support you with:

• Cognitive Behavioural Therapy for Insomnia (CBT-I): The gold-standard, evidence-based first-line treatment for chronic sleep problems.
• NHS Talking Therapies / Counseling: Evidence-based psychological support for underlying anxiety and agitation.
• Alternative Medications: Where appropriate, non-addictive medications that are safe for longer-term symptom management.
• Lifestyle and Sleep Hygiene Advice: Practical, evidence-based guidance to help restore natural sleep patterns and manage stress.

Specialist Psychiatry Care

Please note that if you are under the active care of a specialist psychiatric team, and they determine that continuing one of these medications is clinically essential for your specific mental health treatment, the responsibility for prescribing and monitoring that medication will remain entirely with the psychiatry team. Our GP practice will not take over or issue these prescriptions on a repeat basis.

A Note from Our Clinical Team:

We appreciate that this policy may be disappointing or concerning if you have relied on these medications. Please be assured that this decision is made entirely with your safety and long-term health in mind. We are here to support you through this transition.