Stopping the drug so abruptly will cause a person to have very intense withdrawal symptoms that can occur very quickly. Their levels of physical dependency and psychological addiction also come into play when determining the severity of withdrawal symptoms. Physical symptoms of benzodiazepine withdrawal are slurred speech, impaired vision, vomiting, and flu-like symptoms. Benzodiazepines are habit-forming prescription drugs used to treat several stress-related conditions, such as anxiety disorders, insomnia, epilepsy and even alcohol withdrawal.
Several types of benzodiazepines are sold under popular brand names like Valium (diazepam), Xanax (alprazolam), and Klonopin (clonazepam). The elimination half-life of diazepam and chlordiazepoxide, as well as other long half-life benzodiazepines, is twice as long in the elderly compared to younger individuals. The reason it took 24 weeks for improvements to be seen after cessation of benzodiazepine use was due to the time it takes the brain to adapt to the benzodiazepine-free environment. Some cognitive abilities, which are sensitive to benzodiazepines, as well as age, such as episodic memory, did not improve. Improvements were seen between 24 and 52 weeks after withdrawal in many factors, including improved sleep and several cognitive and performance abilities.
Short-term symptoms
If you take benzodiazepines infrequently, such as once a week or once every few weeks to treat panic attacks, you can take them for a longer period of time. Consequently, experts recommend you take benzodiazepines for no more than 2 weeks if you use them daily. When you stop taking them, you may experience symptoms of withdrawal. Anyone experiencing troubling symptoms from withdrawal, such as suicidal thoughts or tendencies, should seek immediate medical care. Medical detox may help the person manage their specific withdrawal symptoms. Protracted withdrawals may cause their own set of symptoms, often called post-acute withdrawal symptoms, or PAWS.
It’s usually used in mental health treatment, and has sedative, anxiolytic and muscle relaxant properties. If you have any concerns or questions about your medication, it’s crucial that you speak to a healthcare professional, who will be able to offer advice and support. These can include things like lingering anxiety and irritability, and difficulty sleeping.
Types of benzodiazepines
Medical experts continue to debate the best way to taper these medications, so there’s no single agreed-upon approach. But if you remove the drug all at once, your brain doesn’t have enough time to prepare, and you can develop life-threatening symptoms like seizures. All those extra chemicals flood your brain, and the excess activity causes symptoms like anxiety and sweating.
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People tapering off the same original dosage of medication can have drastically different tapering experiences. When tapering off benzodiazepines, you’ll always want to work with a trained healthcare professional who can monitor you for side effects and adjust your pace accordingly. If you take an intermediate-acting benzodiazepine, like alprazolam, or a long-acting benzodiazepine, like diazepam, it may take longer for withdrawal symptoms to appear. Short-term withdrawal symptoms happen shortly after you discontinue your medication. While they can quickly relieve symptoms of anxiety and panic, these drugs pose a high risk of dependence. Symptoms tend to start a few hours to days after the person stops taking the drugs, and they may last for a few weeks to many months before going away.
Withdrawal symptoms can occur after as little as one month of use, even on small, therapeutic doses. Withdrawing from benzodiazepines can be a difficult, even dangerous process. From 1996 to 2013, the number of people filling benzodiazepine prescriptions increased by 67%. The primary difference between these drugs is the length of time they stay active in the body.
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A slow taper would involve reducing your dose by 1 mg (5%) every 4 weeks. For example, say you’re tapering off a dose of 20 milligrams (mg) of diazepam (Valium). The 2022 survey mentioned above also asked respondents to what extent withdrawal symptoms affected their lives. In addition to the immediate health risk, benzodiazepine withdrawal can seriously affect your quality of life. That’s what makes it essential to stop taking benzodiazepines slowly, with support from a medical professional.
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Enduring, self-paced, on-demand microlearning videos that highlight key takeaways from the guideline in interactive question-and-answer formats. Benzodiazepines (BZDs) are commonly prescribed, and FDA approved to treat a wide range of conditions including anxiety and mood disorders, insomnia, and seizures. Some supplements, such as valerian and melatonin, might also help you get some relief from your symptoms, but research has found mixed results.
- Anyone experiencing troubling symptoms from withdrawal, such as suicidal thoughts or tendencies, should seek immediate medical care.
- A significant minority of people withdrawing from benzodiazepines, protracted withdrawal syndrome which can sometimes be severe.
- A series of live webinars intended for clinicians to gain expertise to navigate the complexities of safely tapering benzodiazepines.
- Join leaders in the field of addiction medicine.
What is the most important information I should know about benzodiazepine withdrawal?
Some people, such as those with a history of complicated withdrawal, seizures, or severe mental illness, may be better suited for an inpatient setting. You should plan to stay in touch with your doctor regularly during the tapering process, either by phone or during office visits. Your doctor can pause or slow down the taper if your symptoms are intolerable. Some people taper quickly, finishing up within two to three weeks. Short-acting benzodiazepines complicate withdrawal with too many ups and downs.
Treatment for withdrawal usually involves weaning over a 3- to 21-day period if the infusion lasted for more than a week. The likelihood of having the syndrome correlates with total infusion duration and dose, although duration is thought to be more important. The change in symptoms has been proposed to be due to changes in receptor sensitivity for GABA during the process of tolerance reversal. Symptoms continue to improve over time, often to the point where people eventually resume their normal lives, even after years of incapacity. A study testing neuropsychological factors found psychophysiological markers differing from normals, and concluded that protracted withdrawal syndrome was a genuine iatrogenic condition caused by the long-term use.
Causes & Risk Factors
- A multidisciplinary group led by the American Society of Addiction Medicine (ASAM) undertook the development of the Guideline in response to growing concerns about the risks of long-term benzodiazepine use, a class of medications prescribed for anxiety, sleep disorders, and other indications.
- If you take benzodiazepines infrequently, such as once a week or once every few weeks to treat panic attacks, you can take them for a longer period of time.
- There is no standard tapering schedule for you to follow.
- The authors, however, cited a study in younger patients who at a 3.5-year follow-up showed no memory impairments and speculated that certain memory functions take longer to recover from chronic benzodiazepine use and further improvements in elderly people’s cognitive function may occur beyond 52 weeks after withdrawal.
The severity and length of the withdrawal syndrome is likely determined by various factors, including rate of tapering, length of use and dosage size, and possible genetic factors. A meta-analysis found cognitive impairments in many areas due to benzodiazepine use show improvements after six months of withdrawal, but significant impairments in most areas may be permanent or may require more than six months to reverse. The causes of persisting symptoms are a combination of pharmacological factors such as persisting drug induced receptor changes, psychological factors both caused by the drug and separate from the drug and possibly in some cases, particularly high dose users, structural brain damage or structural neuronal damage. Tinnitus occurring during dose reduction or discontinuation of benzodiazepines is alleviated by recommencement of benzodiazepines.
The Guideline was developed by a group of leading medical and professional societies representing psychiatrists, neurologists, family practice providers, addiction medicine specialists, geriatricians, obstetricians, medical toxicologists, psychiatric pharmacists, and advanced practice providers. In most circumstances, this involves committing to a slow, thoughtful, and careful tapering approach that sets them up for long-term success.” Given the variability in patient reactions to tapering, the Guideline recommends a slow, patient-centered tapering process that is adjusted based on the patient’s response.
Doctors may use certainmedications to manage drug cravingsand withdrawal symptoms during medical detox. Since benzodiazepines impact the mind and body, the drug’s withdrawal symptoms do as well. Poster with engaging graphics and key guideline takeaways to increase awareness and understanding among patients on safe tapering of benzodiazepines.
Verify your insurance today – treatment could be more affordable than you think. This is the best time of year to begin treatment. Join leaders in the field of addiction medicine Join Benzodiazepine withdrawal leaders in the field of addiction medicine. Receive timely and useful news briefings of top stories in addiction policy, combined with ASAM developments related to national and state addiction medicine advocacy.
Benzodiazepine withdrawal symptoms start within one to six hours, and the drug can stay in the body up to 28 days. Quick guide for patients on tapering benzodiazepines. A concise six-page guide that provides evidence-based strategies for safely tapering patients from benzodiazepines. Sometimes altering your tapering schedule can reduce withdrawal symptoms. If you experience unpleasant withdrawal symptoms during your taper, your care team can help you explore options to address those symptoms and get relief.