Bromazepam (Lexotan, Lectopam)

Reviewed by the HeyPsych Medical Review Board

Board-certified psychiatrists and mental health professionals

Published December 1, 2025•Updated December 1, 2025•Reviewed December 1, 2025

Clinical summary for Bromazepam (Lexotan, Lectopam): Bromazepam is a calming medicine used in some countries (not in the US) to treat strong anxiety. It usually starts to work within about an hour and can last through much of the day. Many people feel less tense and less on edge, but also more sleepy or mentally slowed. It can be habit-forming, especially if taken every day for weeks or months. Stopping suddenly after regular use can cause strong rebound anxiety and other withdrawal symptoms, so doses must be reduced slowly with a doctor’s guidance. Never mix bromazepam with alcohol, opioids, or other strong sedatives.

What It's Used For

Bromazepam is used in many countries (but not the United States) as a short-term medicine for strong anxiety symptoms. It is meant to calm you quickly while other longer-term treatments have time to work.

Primary Indications

Severe or disabling anxiety: When worry, tension, or restlessness interfere with daily life.Generalized Anxiety Disorder (GAD): Ongoing, hard-to-control worry about many areas of life.Short-term relief in stressful situations: For example, major life events or medical procedures, when anxiety becomes overwhelming.Bridge treatment: Temporary relief while longer-acting treatments (like SSRIs or therapy) are started or adjusted, which may take 4–6 weeks to fully help.

Off-Label Uses

Panic attacks or panic-like episodes (short-term, with close monitoring).Severe insomnia related to anxiety (only for brief use).

What People Often Notice

Everyone is different, but these are common things people report while taking bromazepam:

Relief of Anxiety (First Hour or Two)

"“The tight feeling in my chest eased and I could breathe again.”"

How Fast It Works and How Long It Lasts

Bromazepam is not the very fastest benzodiazepine, but it still works fairly quickly and lasts much of the day.

30–60 minutes

Many people start to notice calming effects.

1–4 hours

Effects are usually at their strongest.

Most of the day

A single dose can last many hours; when used regularly, it is often taken 2–3 times per day.

10–20 hours

Average time for half of the medicine to leave your body (half-life) – longer in some older adults.

Because it lasts longer than some other anti-anxiety medications, it can build up in the body with repeated doses, especially in older adults or people with liver problems.

How Well It Works

Improvement in Anxiety Symptoms at 4 Weeks

Active treatment better than placebo

vs Bromazepam slightly stronger than diazepam on some measures

In a 4-week clinical trial, adults with generalized anxiety were randomly assigned to bromazepam, diazepam, or placebo (a sugar pill). Starting in the first week, both medications reduced anxiety more than placebo. Bromazepam showed somewhat stronger improvement than diazepam on physical anxiety symptoms (like muscle tension and bodily discomfort) and overall anxiety scores on standard rating scales.

Critical Safety Information

Never mix bromazepam with alcohol, opioids (like oxycodone or morphine), or other strong sedatives unless a doctor is closely supervising you. This combination can slow or stop breathing and can be fatal.

→Avoid alcohol completely while taking bromazepam. Even a few drinks can be dangerous.
→Do not stop bromazepam suddenly if you have been taking it regularly. Work with your prescriber on a slow dose reduction plan.
→Tell your doctor if you have a history of substance use, breathing problems, sleep apnea, liver disease, or depression.
→Do not drive, use heavy machinery, or do risky activities until you know how bromazepam affects your alertness and coordination.
→Keep tablets locked away and out of reach of children and others; benzodiazepines have a street value and can be misused.
→Contact your doctor urgently or seek emergency care if you notice extreme sleepiness, trouble breathing, confusion, or very unusual behavior.

Side Effects

The most common side effects are sleepiness, dizziness, slowed thinking, and unsteady balance. These risks are higher with bigger doses, in older adults, and when combined with other sedating medicines or alcohol.

Common Things People Notice

Feeling very sleepy or drowsy, especially a few hours after a dose.
Feeling mentally slowed, foggy, or less able to concentrate.
Unsteady balance or feeling “wobbly” on your feet (higher fall risk).
Blurred vision or double vision.
Dry mouth, nausea, or mild stomach upset.
Changes in sex drive (up or down).

Common Side Effects

Very common

Sleepiness and Fatigue— You may feel calmer but also more tired, especially when starting or after dose increases. Try to take doses at times when feeling sleepy will be less disruptive, and avoid driving until you know how you react.

Common

Dizziness and Unsteady Gait— You may feel off-balance or light-headed, similar to having had a few drinks. This can increase the chance of falls, especially in older adults. Be careful on stairs and in the bathroom.

Common

Cognitive Slowing and Memory Problems— You may think more slowly, have trouble focusing, or notice gaps in memory for events that happened after taking a dose. Important decisions or detailed work are best done before taking bromazepam.

Less common

Mood and Behavior Changes— A small number of people can have the opposite reaction: agitation, irritability, unusual risk-taking, or aggression. If you or others notice big behavior changes, contact your doctor right away.

Uncommon

Liver or Blood Test Changes— Occasionally, routine blood tests may show mild changes in liver or kidney markers. Your doctor may check labs if you are taking bromazepam regularly for a longer time.

⚠️ Serious Side Effects

Severe sleepiness, confusion, or difficulty staying awake.
Slow, shallow, or difficult breathing – especially if combined with opioids, alcohol, or other sedatives (medical emergency).
New or worse depression, suicidal thoughts, or feeling emotionally numb and detached.
Unusual agitation, rage, hallucinations (seeing or hearing things that aren’t there), or very out-of-character behavior.
Seizures, especially after abruptly stopping bromazepam or rapidly cutting the dose.
Severe allergic reaction: swelling of the lips, tongue, or throat; trouble breathing; hives (call emergency services).

Important Drug and Substance Interactions

Bromazepam is processed by the liver and strongly affects the brain. Many medicines and substances can increase its side effects or change how long it stays in your body.

With: Opioid pain medicines (eg, codeine, oxycodone, morphine, hydromorphone, fentanyl)

Risk: Very high risk of dangerous sleepiness, slowed breathing, coma, and death when combined.

Action: Avoid combining whenever possible. If your doctor feels both are absolutely necessary, they should use the lowest effective doses and monitor you closely. Loved ones should know overdose warning signs and how to get emergency help.

With: Alcohol

Risk: Major increase in drowsiness, poor coordination, and breathing suppression. Strongly increases accident and overdose risk.

Action: Do not drink alcohol while taking bromazepam. Even small amounts (1–2 drinks) can be risky.

With: Other sedating medicines (sleeping pills, other benzodiazepines, some antihistamines like diphenhydramine, muscle relaxants, antipsychotics, some antidepressants)

Risk: Add-on effects: more sedation, worse balance, slower thinking, and more trouble breathing.

Action: Your doctor may lower doses or avoid these combinations. Always tell your prescriber and pharmacist about all medicines, including over-the-counter sleep aids or allergy pills.

With: Medicines that affect liver enzymes (eg, cimetidine, some antifungals, certain antibiotics, HIV medicines)

Risk: Can raise bromazepam blood levels, leading to stronger and longer-lasting effects.

Action: Your doctor may adjust your dose or choose a different medicine. Do not start or stop these medicines without medical advice.

With: Cannabis, opioids for cough or diarrhea, gabapentin/pregabalin, or other calming herbal products (eg, valerian, kava)

Risk: Extra sedation, slower reaction time, and higher risk of accidents or breathing problems.

Action: Use together only if your doctor agrees and monitors you. Avoid driving and other risky activities, and report any extreme drowsiness or breathing issues.

Stopping Bromazepam Safely

If you have been taking bromazepam regularly, your brain and body can get used to it. Stopping suddenly can cause significant withdrawal symptoms, including severe anxiety and, in some cases, seizures. A gradual dose reduction (taper) is usually needed.

Key Points

Never stop suddenly after regular use. Always check with your prescriber first.
Mild, short-term use (a few weeks at low doses): Many people can lower the dose by about 20–25% every 1–2 weeks, with adjustments based on symptoms.
Longer-term or higher-dose use: Dose cuts are usually smaller (for example, about 10–25% of the current dose every 1–2 weeks), slowing down if withdrawal symptoms appear.
Common withdrawal symptoms include: strong rebound anxiety, trouble sleeping, irritability, restlessness, tremor, sweating, feeling shaky, and flu-like discomfort.
Serious withdrawal (less common but dangerous) can include: confusion, hallucinations, severe agitation, and seizures. This is more likely with high doses or abrupt stopping.
Your doctor may suggest switching to another benzodiazepine with a longer half-life to make tapering smoother in some cases.
Non-medicine supports (therapy, breathing exercises, good sleep habits, avoiding caffeine and alcohol) can make tapering more tolerable.

Dosing Basics (For Patient Education)

Adult Dosing

anxiety initial: Adults often start around 6–18 mg per day, divided into 2–3 doses (for example morning, midday, and evening).

anxiety titration: Your doctor may adjust the dose slowly over several days to find the lowest amount that controls your symptoms.

anxiety max: Some adults may go up to 30 mg per day in divided doses; higher doses increase side effects and dependence risk and are usually reserved for special situations under specialist care.

debilitated: Older or frail adults often start at about 3 mg per day in divided doses and are increased very cautiously, if at all.

prn use: Some people use bromazepam only “as needed” for short periods of intense anxiety. Even with this approach, your doctor will set a maximum daily dose and frequency to reduce dependence risk.

Simple Explanation

Because bromazepam can make you sleepy and affects your thinking and coordination, doctors try to use the smallest dose that still helps. It is usually meant as a short-term helper, not a long-term stand-alone solution for anxiety.

Pregnancy, Breastfeeding, and Special Groups

Bromazepam needs extra caution in certain groups. Always tell your prescriber if you are pregnant, planning pregnancy, breastfeeding, older than 65, or have other serious health conditions.

👶Pregnancy

Use during pregnancy is generally avoided unless there is no safer option and the anxiety is severe. Benzodiazepines can cross the placenta and may cause low muscle tone, breathing problems, and withdrawal symptoms in newborns, especially with regular use later in pregnancy. Anxiety itself can also affect pregnancy outcomes, so any decision about treatment should be made together with your obstetric and mental health providers.

🤱Breastfeeding

Bromazepam passes into breast milk. Case reports with benzodiazepines describe sleepy or poorly feeding infants. Many guidelines advise avoiding regular use while breastfeeding or using the lowest effective dose for the shortest time, with close monitoring of the baby for sleepiness, poor feeding, or poor weight gain.

👧Children & Adolescents (Under 18)

Not recommended for children due to limited safety data and higher risk of behavior changes and breathing problems.

👴Older Adults (65+)

Older adults are more sensitive to bromazepam’s effects. They have higher risks of confusion, memory problems, and falls. If used at all, doses should be low, increased slowly, and reviewed often. Many guidelines suggest avoiding benzodiazepines in older adults when possible.

🔬Liver Impairment

Because bromazepam is processed in the liver, people with liver disease may clear it more slowly and be more prone to side effects. Severe liver disease is a contraindication.

💧Kidney Impairment

Kidney disease may change how long breakdown products stay in the body. Doctors may start with lower doses and monitor more carefully.

What Clinicians Usually Monitor

Anxiety symptoms and overall functioning: Is day-to-day life getting easier, or is sedation getting in the way?
Signs of misuse: running out early, taking higher doses than prescribed, or using with alcohol or other drugs.
Sleepiness, balance, and falls: especially in older adults or those taking other sedating medicines.
Breathing: in people with lung disease or sleep apnea, or in anyone also taking opioids or other respiratory depressants.
Mood and behavior: new or worse depression, irritability, or unusual behavior changes.
Withdrawal signs: if doses are missed or reduced, especially after long-term use.
Lab tests (if used longer term): occasional liver and kidney function tests, and blood counts, based on individual risk.

Available Forms (May Vary by Country)

Oral tablets: 1.5 mg, 3 mg, and 6 mg strengths (various brands and generics).
Taken with or without food, usually 1–3 times per day as directed.

How It Works in the Brain

Bromazepam belongs to the benzodiazepine family. It does not create calmness on its own; instead, it boosts the effect of GABA, the brain’s main “brake” or calming chemical. When GABA attaches to its GABA-A receptor, it opens a channel that lets chloride ions into the nerve cell, making it less likely to fire. Bromazepam helps GABA open this channel more easily. The result is that overactive brain circuits involved in fear, worry, and physical tension are dampened, which reduces anxiety – but also slows thinking and can cause drowsiness.

Where Bromazepam Fits in Anxiety Treatment

Bromazepam can be very helpful for short-term relief of strong anxiety symptoms, but it is not usually a first-choice long-term treatment. Most guidelines recommend therapies like cognitive-behavioral therapy (CBT) and antidepressant medicines such as SSRIs or SNRIs as the main treatments for anxiety disorders. Bromazepam is often used as a temporary helper at the beginning or during severe flare-ups, with a clear plan to reduce and stop it once more sustainable treatments are working.

References & Further Reading

Fontaine et al. (1983) – Bromazepam and Diazepam in Generalized Anxiety Lexotan (Bromazepam) Product Information Bromazepam – PubChem Entry DrugBank: Bromazepam (DB01558)e-Lactancia – Bromazepam and Breastfeeding

Frequently Asked Questions

What is bromazepam used for?

Bromazepam is used in many countries (but not in the United States) to treat short-term, severe anxiety. It can help with symptoms like constant worry, feeling wound-up, muscle tension, and physical restlessness. Because it can be habit-forming, it is usually used only for limited periods or during particularly difficult times, not as a stand-alone long-term treatment.

How fast does bromazepam work?

Most people start to notice calming effects within 30–60 minutes after taking a dose. The strongest effects are usually felt within the first few hours. The medicine stays in your system for much of the day, which is why it’s often taken 1–3 times per day if used regularly.

Is bromazepam available in the United States?

No. Bromazepam is not marketed in the US. If you live in the United States and have a tablet labeled bromazepam or Lexotan, it likely came from another country, and you should discuss this with a licensed US prescriber. Other benzodiazepines, like alprazolam (Xanax) or lorazepam (Ativan), are more commonly used in the US.

Can bromazepam be addictive?

Yes. Like all benzodiazepines, bromazepam can lead to physical and psychological dependence, especially if taken every day for more than a few weeks or at higher doses. You may feel you ‘need’ it to get through the day, and stopping suddenly can cause strong withdrawal symptoms. To reduce this risk, doctors aim for the lowest effective dose and the shortest possible treatment time, and may plan a gradual taper when it’s time to stop.

What are the most common side effects?

The most common side effects are drowsiness, feeling tired or weak, dizziness, slowed thinking, and problems with memory or concentration. Some people feel off-balance or notice blurred vision. These effects are stronger with higher doses, in older adults, or when bromazepam is combined with alcohol or other sedating medicines.

Can I drink alcohol while taking bromazepam?

No. Alcohol and bromazepam both slow the brain and nervous system. When taken together, they can strongly increase sleepiness, poor coordination, and breathing problems. This combination is a common factor in serious accidents and overdoses, and should be avoided completely.

Is bromazepam safe during pregnancy?

Bromazepam, like other benzodiazepines, can cross the placenta and may affect the baby, especially if used regularly or later in pregnancy. Possible problems include low muscle tone, breathing difficulties, and withdrawal symptoms in the newborn. At the same time, untreated severe anxiety can also harm pregnancy outcomes. If you are pregnant or planning to become pregnant, do not stop or start bromazepam on your own—talk with your obstetric and mental health providers to weigh the risks and benefits and consider safer alternatives when possible.

Can I use bromazepam while breastfeeding?

Bromazepam and its breakdown products are expected to appear in breast milk. Some benzodiazepines have caused sleepiness or poor feeding in breastfed babies. Many experts advise avoiding regular bromazepam use while breastfeeding, or using the lowest effective dose for the shortest time with close monitoring of the baby. If you are breastfeeding, talk with your doctor about whether a different treatment might be safer and what signs to watch for in your baby.

What happens if I stop bromazepam suddenly?

If you have been taking bromazepam regularly, stopping suddenly can cause withdrawal symptoms. These may include strong rebound anxiety, trouble sleeping, irritability, sweating, tremors, and in some cases, confusion or seizures. The risk is higher with higher doses and longer use. To come off bromazepam safely, your doctor will usually reduce your dose slowly over weeks or months, depending on how long you’ve been taking it.

How long can I safely take bromazepam?

Labels and guidelines usually recommend using bromazepam only for short periods (often 2–4 weeks), including the time spent slowly reducing the dose. Some people do take it longer under careful specialist supervision, but the risks of dependence, falls, and thinking problems grow over time. It’s important to have a clear plan with your prescriber about how long you’ll use it and how you’ll eventually taper off.

What’s the difference between bromazepam and other benzodiazepines like lorazepam or alprazolam?

All benzodiazepines work by boosting GABA, the brain’s main calming chemical. The main differences are how fast they start, how long they last, how strongly they affect sleepiness vs. anxiety, and what’s available in your country. Bromazepam has an intermediate half-life and is used mainly in Europe, Canada, and some other regions. Lorazepam and alprazolam are more commonly used in the US. Your doctor will choose based on your symptoms, other medications, and medical history.

What should I do if I miss a dose?

If you take bromazepam regularly and miss a dose, take it when you remember unless it is close to the time for your next dose. Do not double up doses to ‘catch up.’ If you are unsure what to do, contact your prescriber or pharmacist. If you start feeling withdrawal symptoms (strong anxiety, restlessness, trouble sleeping), let your doctor know.

This medication information is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider before starting, stopping, or changing any medication. Never take medication without a prescription from a licensed healthcare provider.

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Bromazepam (Lexotan, Lectopam)

Reviewed by the HeyPsych Medical Review Board

Board-certified psychiatrists and mental health professionals

Published December 1, 2025•Updated December 1, 2025•Reviewed December 1, 2025