Withdrawing from Benzodiazepines: Symptoms, Safety, and Treatment

Benzodiazepines are a powerful class of medication used to treat anxiety, insomnia, and panic disorder. Examples of benzodiazepines include alprazolam (Xanax) and diazepam (Valium). Longer-acting benzodiazepines like Klonopin (clonazepam) can stay in the system longer, which means it can be one to two days or even longer before withdrawal symptoms start. Patients may have been taking benzodiazepines for an anxiety or other psychological disorder; following withdrawal from benzodiazepines, the patient is likely to experience a recurrence of these psychological symptoms. Patients should be offered psychological care to address these symptoms. The safest way to manage benzodiazepine withdrawal is to give benzodiazepines in gradually decreasing amounts.

Along with these symptoms, the person may experience severe cravings for the drug or other drugs to sedate them. People looking to get off benzos should do so under the guidance of a healthcare professional, who may recommend coping strategies and other tools to make the withdrawal process more comfortable. These drugs are habit-forming and can easily result in physical dependence. This dependence may lead to a difficult withdrawal if the person chooses to stop taking the drugs. Emerging research also suggests acceptance and commitment therapy (ACT) could also have benefits during https://ecosoberhouse.com/article/how-to-make-your-home-more-environmentally-friendly/.

Treatment Options for Benzodiazepine Withdrawal

Many medications have been tested to alleviate withdrawal symptoms and make it easier for patients to discontinue BZD since a gradual taper does not always lead to successful discontinuation of the drug. Currently, a gradual taper with clonazepam is used as maintenance therapy for BZD-dependent patients. However, it still carries the risk for abuse and dependence since this is also a BZD, albeit a slow-acting one [67]. Still, due to the severe potential for dependence and deadly withdrawal sequelae, guidelines for recommended use are no longer than a few weeks. Despite this, numerous studies report usage extending for months into years or even decades in many users [9].

  • Other important indications for the use of BZDs include the treatment of catatonia, seizure disorders, and alcohol and BZD withdrawal.
  • The usual initial dosage of diazepam or lorazepam is titrated according to elevations of blood pressure, pulse rate, degree of agitation and presence of delirium.
  • The cannabis withdrawal syndrome is typically mild, but can be difficult for the patient to cope with.
  • Benzodiazepines have a sedative effect because of how they work in your brain.
  • However, that doesn’t necessarily mean you will require inpatient care.

In 2016, estimates suggest that about half a million people in the United States misused sedative drugs. The primary difference between these drugs is the length of time they stay active in the body. However, benzodiazepines can cause physical dependence and withdrawal even when they are taken as directed. Benzodiazepines are a group of central nervous system depressants used to treat anxiety, insomnia, and seizures.

Symptoms of Benzo Withdrawal

Captodiamine is a diphenhydramine-related compound that does not work at histamine receptors as diphenhydramine does and its mechanism of action is unclear [70]. This drug has also been studied in the context of both BZD replacement and withdrawal as a potential treatment [70]. One study showed that replacing BZD with a 45 day captodiamine led to a decrease in severity of withdrawal symptoms in patients taking BZD for six months [70]. Another interesting finding was that after the discontinuation of captodamine treatment, there was no emergence of withdrawal symptoms, suggesting that captodiamine might have a different mechanism of anxiolysis than BZD [70]. Additionally, during captodiamine treatment, psychomotor function improved in all areas tested from beginning to end of treatment [70]. It must be noted that these patients were taking relatively low doses of BZD pre-treatment [70].

One study compared the mainstay of treatment with a standardized interview/counselling approach to treatment [72]. The experimental group in this study had a weekly 1/10-dose reduction after a 2 week stabilization period [72]. The experimental treatment benzodiazepine withdrawal also included a BZD diary, a drinking diary, BZD withdrawal education, and assessments for ways of coping and “progressive relaxation exercise” [72]. This was compared to a gradual taper without the other components of the treatment plan [72].

What happens when you stop taking benzodiazepines?

Furthermore, supplemental doses of sedatives taken as needed are usually not required for changes in vital signs5–8 (Table 3). Since benzodiazepines have cross-tolerance within that drug class as well as with other sedative/hypnotic drugs, benzodiazepines can be substituted for other sedative/hypnotics and vice versa. Equivalent doses can be calculated if the actual doses are known before beginning the tapering process (Table 4).

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