Hitting the Gas and the Brakes: A Literature Review of Stimulant and Benzodiazepine
Location
LSUHSC-NO
Publication Date
April 2026
Start Date
9-4-2026 10:00 AM
End Date
9-4-2026 2:00 PM
Description
Attention-deficit hyperactive disorder (ADHD) and anxiety disorders are two of the most prevalent diagnoses for which individuals seek outpatient psychiatric treatment. It is not uncommon for patients to present with comorbid ADHD and anxiety disorders that often necessitates the use of more than one medication for adequate treatment. Stimulant medications (i.e. amphetamine- or methylphenidate-based compounds) are schedule II-controlled substances that are FDA-approved for the treatment of ADHD and narcolepsy. Benzodiazepines (e.g., alprazolam, clonazepam) are schedule IV-controlled substances that have FDA approval for multiple indications including anxiety disorders (e.g., generalized anxiety disorder and panic disorder). Concomitant prescription of benzodiazepines and stimulants is heavily scrutinized given each medication class's risk of abuse, the opposing actions/effects of the two medications, and the presumed increased risk of adverse events. The objective of this review is to describe the prevalence of co-prescription, the incidence of adverse events associated with co-prescription, the effects of co-prescription on clinical outcomes, and to identify gaps in the literature where additional studies are needed.
An estimated 3 -13% of individuals who are taking stimulants are also prescribed benzodiazepines, most commonly alprazolam. Despite the regular prevalence of this combination, there is a paucity of literature explicitly examining the clinical consequences of co-prescription. Small, controlled trials suggest that benzodiazepines attenuate some physiologic and psychologic effects of stimulant medications. Notably, one retrospective cohort study found that adolescents with ADHD who are prescribed benzos and stimulants are at increased risk of developing SUD relative to adolescents with ADHD treated with stimulants or benzodiazepines alone. Additional research is needed to better characterize whether stimulant - benzodiazepine co-prescription increases the risk of adverse events or modifies clinical outcomes.
Recommended Citation
Stielper, Zachary MD, PhD; Choi, Kwon; Duffy, Sharon MLIS; and Conrad, Erich MD, "Hitting the Gas and the Brakes: A Literature Review of Stimulant and Benzodiazepine" (2026). Dept. of Psychiatry Research Symposium. 8.
https://digitalscholar.lsuhsc.edu/psych_rd/2026/posters/8
Hitting the Gas and the Brakes: A Literature Review of Stimulant and Benzodiazepine
LSUHSC-NO
Attention-deficit hyperactive disorder (ADHD) and anxiety disorders are two of the most prevalent diagnoses for which individuals seek outpatient psychiatric treatment. It is not uncommon for patients to present with comorbid ADHD and anxiety disorders that often necessitates the use of more than one medication for adequate treatment. Stimulant medications (i.e. amphetamine- or methylphenidate-based compounds) are schedule II-controlled substances that are FDA-approved for the treatment of ADHD and narcolepsy. Benzodiazepines (e.g., alprazolam, clonazepam) are schedule IV-controlled substances that have FDA approval for multiple indications including anxiety disorders (e.g., generalized anxiety disorder and panic disorder). Concomitant prescription of benzodiazepines and stimulants is heavily scrutinized given each medication class's risk of abuse, the opposing actions/effects of the two medications, and the presumed increased risk of adverse events. The objective of this review is to describe the prevalence of co-prescription, the incidence of adverse events associated with co-prescription, the effects of co-prescription on clinical outcomes, and to identify gaps in the literature where additional studies are needed.
An estimated 3 -13% of individuals who are taking stimulants are also prescribed benzodiazepines, most commonly alprazolam. Despite the regular prevalence of this combination, there is a paucity of literature explicitly examining the clinical consequences of co-prescription. Small, controlled trials suggest that benzodiazepines attenuate some physiologic and psychologic effects of stimulant medications. Notably, one retrospective cohort study found that adolescents with ADHD who are prescribed benzos and stimulants are at increased risk of developing SUD relative to adolescents with ADHD treated with stimulants or benzodiazepines alone. Additional research is needed to better characterize whether stimulant - benzodiazepine co-prescription increases the risk of adverse events or modifies clinical outcomes.