It is essential for healthcare providers to carefully manage the tapering process to minimize benzodiazepine withdrawal the risk of withdrawal syndrome in patients using benzodiazepines. When opioids are tapered, short-acting forms of those medications can be added to ameliorate the withdrawal symptoms while the long-acting opioids are decreased over time. This strategy, however, is not recommended for benzodiazepines because of a central nervous system process called kindling.
Long-Term Treatment for Benzodiazepine Withdrawal
If you’re predisposed to seizures, your risk of having a seizure may also increase during the withdrawal period. During your taper, you may still experience some of the symptoms of withdrawal. Benzodiazepine withdrawal can be managed with a gradual dose reduction, which will cause milder symptoms that come and go in waves. Benzodiazepine withdrawal can also lead to disturbances in mental function that persist for several months or years after onset of symptoms (referred to as post-acute-withdrawal syndrome in this form).
Signs and Symptoms of Benzodiazepine Withdrawal
Your doctor will help make an individualized tapering schedule based on your current dose and particular circumstances. Withdrawing from benzodiazepines can be a difficult, even dangerous process. During the first week, you can also expect physical symptoms like headaches and hand tremors.
- You may remove weapons or substances that can cause harm if you can do so safely.
- During withdrawal (whether due to tolerance or tapering) and recovery, patients often experience an irregular, unpredictable cycling between relative lessening and exacerbation of symptoms.
- If not already using a long half-life benzodiazepine like clonazepam or diazepam, transitioning to an equivalent dose (see Table) of either of these agents prior to tapering often allows for a smoother tapering process.
- Click here to access the reference library, which provides links to over 1000 benzodiazepine-related scholarly papers.
- Continuing the prescription of benzodiazepines will please the patient, but not cure the problems.
Management
Patients typically need a lot of support from family, friends, and ideally, peer coaching. Informed consent means all involved – including the physician – should know and understand what to anticipate and the nature of the process – all established through shared decision-making. The use of Cognitive Behavioral Therapy (CBT) can be valuable, and adjunctive medications (see list) may be considered. In addition, 76.2 percent of respondents had not been informed that benzodiazepines are approved for short-term use only and that discontinuation might be difficult. The Drug Enforcement Agency (DEA) classify benzodiazepines as a Schedule IV controlled substance.
Tapering off supratherapeutic doses
One in five (20.6 percent) had difficulty breathing or swallowing on a protracted basis, and more than one in four (28.3 percent) reported periods of uncontrollable crying or anger. Tapering the drug by slowly reducing the prescription strength may help make withdrawal symptoms much easier to manage. Additionally, medical supervision allows doctors to respond much more quickly to potential side effects and withdrawal symptoms.
Prescription drug detox typically begins with an assessment so professionals can gain an understanding of your level of physical and psychological dependence on the drug. At this stage, medications and therapies can be used to ease your withdrawal symptoms. Note that, unlike most addiction-prone drugs, there is little evidence of post-taper patients craving benzodiazepines.
Post-acute withdrawal syndrome (PAWS) is a collection of related symptoms, including mood swings, sleep disturbances and intense cravings that can persist for weeks or even months. Benzodiazepines are commonly prescribed medications primarily intended for managing conditions such as anxiety disorders, panic disorders, and insomnia. These pharmaceutical agents work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, leading to reduced anxiety, muscle relaxation, and sedation. Due to their rapid onset of action, they are also used to alleviate acute episodes of anxiety and agitation. However, their potential for tolerance, dependency, and withdrawal necessitates careful consideration and short-term usage.
- Other therapies, including counseling and cognitive behavioral therapy (CBT), may be helpful for people looking to manage symptoms without relying on other drugs.
- If you want to stop taking benzodiazepines after consistent long-term use, your doctor can help you gradually taper off your medication.
- For long-term benzodiazepine users, this is a tidal shift in thinking, and will take time, reinforcement, and assurance that the prescriber will help them though the withdrawal and recovery processes.
- Withdrawal phenomena appear to be more severe following withdrawal from high doses or short-acting benzodiazepines.
Benzodiazepine, or benzo, withdrawal happens when a person suddenly Alcoholics Anonymous stops taking benzodiazepine drugs, which doctors do not recommend. The withdrawal symptoms, which vary in severity, typically begin within 24 hours and may last from a few days to a few months. Short-acting benzodiazepines, like triazolam, pass quickly through the body, so you’ll likely experience withdrawal symptoms sooner — sometimes within a matter of hours.
Benzodiazepine Withdrawal Syndrome – Symptoms and Treatment
There are three possible phases for benzo withdrawals, each with an estimated timeline. A person should always withdraw from benzos under the guidance of a healthcare professional. They should never quit benzos suddenly without first consulting a professional and developing a plan with them. 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.
