In my clinic, nerve conduction studies in patients with such symptoms revealed nothing abnormal – for example, there was no evidence of peripheral neuritis. Three patients with a combination of numbness, muscle spasms and double vision were diagnosed as having multiple sclerosis. This diagnosis, and all the symptoms, disappeared soon after the patients stopped their benzodiazepines. Severe depression may result from biochemical changes abrupt withdrawal of benzodiazepines may result in: in the brain induced by benzodiazepines.
- Although most studies have not extended beyond a year after withdrawal, the results suggest that improvement continues beyond this time.
- Most of them are actual schedules which have been used and found to work by real people who withdrew successfully.
- 1This article assesses the causes, symptoms, and treatment strategies for benzodiazepine withdrawal, emphasizing the significance of professional guidance during this period.
- Early withdrawal symptoms, also known as rebound symptoms, arise immediately after an individual discontinues benzodiazepines.
Mitigating Factors
- There is scientific evidence that reinstatement of brain function takes a long time.
- Thus, these sensations need not give rise to fear; they can be viewed as signs of recovery.
In any case, weight changes are not severe enough to worry about and normal weight is soon regained after withdrawal. A few people have difficulty in swallowing food – the throat seems to tighten up especially if eating in company. Practising relaxation, eating alone, taking small well chewed mouthfuls with sips of liquid and not hurrying make things easier and the symptom settles as anxiety levels decline. Such experiences probably represent a normal defensive reaction evolved as a protection against intolerable suffering.
Why and How Does Benzodiazepine Withdrawal Occur?
Benzodiazepines are known to decrease the activity of serotonin and norepinephrine (noradrenaline), neurotransmitters believed to be closely involved in depression. Antidepressant drugs including the selective serotonin reuptake inhibitors (SSRIs such as Prozac) are thought to act by increasing the activity of such neurotransmitters. Poor memory and concentration are also features of benzodiazepine withdrawal, and are probably due to continued effects of the drug. Mentors should be prepared to repeat encouragements again and again, week after week, as their words are soon forgotten.
BEFORE STARTING BENZODIAZEPINE WITHDRAWAL
- Others might experience a few weeks or months of uncomfortable, but bearable, symptoms.
- Protracted withdrawal may continue for months or even years after stopping a benzodiazepine drug.
- Dopamine is a type of messenger that is partly responsible for how humans feel pleasure.
- Healthcare providers typically develop a tapering schedule to slowly decrease the benzodiazepine dosage, reducing the risk of severe withdrawal symptoms.
- Some find that the skin and scalp becomes so sensitive that it feels as if insects are crawling over them.
Acute symptoms usually last one to four weeks, with peak intensity in the first fourteen days. However, some individuals may experience protracted withdrawal symptoms, such as anxiety or sleep disturbances, lasting for months or even a year. A slow tapering process under medical supervision alcoholism can reduce the duration and severity of symptoms. The severity of withdrawal symptoms varies between people and depends on a variety of factors.
A third important practical factor is the available dosage formulations of the various benzodiazepines. In withdrawal you need a long-acting drug which can be reduced in very small steps. Diazepam (Valium) is the only benzodiazepine that is ideal for this purpose since it comes in 2mg tablets, which are scored down the middle and easily halved into 1 mg doses. Even by halving these tablets the smallest reduction one could easily make is the equivalent of 2.5mg diazepam. (Some patients become very adept at shaving small portions off their tablets).
Acute withdrawal
Some people take weeks to reduce their dose while others take months to complete the process. The help of a medical or mental health professional is often needed to manage these symptoms successfully. Most people do okay with tapering their benzodiazepines at home with the help of their primary care doctor or psychiatrist. You should plan to stay in touch with your doctor regularly during the tapering process, either by phone or during office visits.
Timeline
They seem to be prone to colds, sinusitis, ear infections, cystitis, oral and vaginal thrush (candida), other fungal infections of the skin and nails, cracked lips, mouth ulcers and influenza. Also common are complaints of adverse reactions to antibiotics used to treat some of the bacterial infections. The advantages of discontinuing benzodiazepines do not necessarily mean that every long-term user should withdraw. On the other hand, the chances of success are very high for those sufficiently motivated. As mentioned before, almost anyone who really wants to come off can come off benzodiazepines.
However, some long-term benzodiazepine users begin to experience “withdrawal” symptoms even though they continue taking the drug. This is due to the development of drug tolerance (Chapter I) which sometimes leads doctors to increase the dosage or add another benzodiazepine. Analysis of the first 50 patients who attended my benzodiazepine withdrawal clinic showed that all of them had symptoms on first presentation while still on benzodiazepines (12 of them were taking two prescribed benzodiazepines at once).