Benzodiazepine withdrawal is a complex but necessary step toward recovery from dependence or misuse. While the process can be physically and emotionally demanding, understanding its mechanisms, timeline, and treatment ensures a safer and more manageable experience. Professional guidance, including gradual tapering and extensive detox programs, plays a vital role in minimizing risks and relieving discomfort. With proper support and supervised interventions, individuals can overcome withdrawal and regain control of their health, paving the way for a successful and lasting recovery. During this stage, the symptoms tend to be most intense as the body tries to adjust to the absence of the drug. Psychological effects, including severe anxiety, irritability, and panic attacks, are common, along with physical symptoms such as muscle tension, headaches, and dizziness.
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- It has been suggested that their use over many years could cause physical changes such as shrinkage of the cerebral cortex, as has been shown in chronic alcoholics, and that such changes may be only partially reversible after withdrawal.
- Like many other issues concerning benzodiazepines, the answers to these questions are still unclear.
- There is some evidence that chronic hyperventilation provokes the release of histamine (a substance released in allergic reactions) and that the incidence of food-intolerance and “pseudo-allergic” reactions is high in chronic hyperventilators.
- Heartbeats become audible and there may be a hissing or ringing sound in the ears (tinnitus – see below).
- If so, the receptors would continue to be resistant to the natural calming actions of GABA (See Chapter I), and the effect could be to prolong the state of nervous system hyperexcitability.
- Population PK analysis in 87 pediatric patients 0.4 – 17.8 years of age with status epilepticus showed that, after initial dosing, the median plasma half-life was 0.5 hours and the median terminal elimination plasma half-life was 18 to 25 hours.
- These medications work by enhancing the effect of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain.
They suggest a dysfunction in motor and sensory pathways in the spinal cord and/or brain. A possible clue to their mechanism is provided by drug addiction treatment a trial with flumazenil (Anexate, Romazicon) a benzodiazepine receptor antagonist, published by Lader and Morton (Journal of Psychopharmacology 1992, 6, ). This drug, when infused intravenously brought rapid relief of protracted symptoms (muscle tension, “pins and needles”, weakness, muscle cramps or jerks, burning, tremor or shaking) that had been present for 5-42 months post-withdrawal in 11 patients. The symptoms were improved by percent and the greatest response occurred in patients with the lowest anxiety ratings.
When do symptoms of abrupt withdrawal start and how long do they last?
He completed his residency in psychiatry in 2008 at Creedmoor Psychiatric Center in New York. Dr. Thankachen sees patients with an array of disorders, including depression, bipolar illness, schizophrenia, anxiety, and dementia-related problems. Yes, many withdrawal symptoms can be managed with the help of healthcare professionals.
Discontinuation or Dosage Reduction of Diazepam Tablets
Your risk of withdrawal may increase if you engage in illicit drug abuse involving benzodiazepines. Rather than (or in addition to) expensive therapists, you need someone reliable, who will support you frequently and regularly, long-term, both during withdrawal and for some months afterwards. Voluntary tranquilliser support groups (self-help groups) can be extremely helpful.
Physical Dependence
Withdrawal phenomena appear to be more severe following withdrawal from high doses or short-acting benzodiazepines. Dependence on alcohol or other sedatives may increase the risk of benzodiazepine dependence, but it abrupt withdrawal of benzodiazepines may result in: has proved difficult to demonstrate unequivocally differences in the relative abuse potential of individual benzodiazepines. The continued use of benzodiazepines, including diazepam may lead to clinically significant physical dependence. Benzodiazepine withdrawal syndrome refers to a set of symptoms that can occur when an individual who has been using benzodiazepines, either as prescribed or inappropriately, suddenly stops or significantly reduces their dosage.
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. Withdrawal symptoms may be mild in people who take the drugs for short periods.
Method of Discontinuation
- If the decision is made to use flumazenil, it should be used as an adjunct to, not as a substitute for, supportive management of benzodiazepine overdosage.
- When the use of the drug is decreased or stopped, the sudden reduction in GABA activity leads to an imbalance, causing the nervous system to become hyperactive, a state manifesting as the myriad symptoms of withdrawal.
- 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.
There is some evidence that chronic hyperventilation provokes the release of histamine (a substance released in allergic reactions) and that the incidence of food-intolerance and “pseudo-allergic” reactions is high in chronic hyperventilators. Advice on diet, breathing and candida infections is given in books by Shirley Trickett quoted at the end of this chapter. It is usually inadvisable to stick to a strict exclusion diet; with a normal balanced diet and sensible general health measures, including regular exercise, gastrointestinal symptoms due to withdrawal gradually abate.
