Chapter 3: Benzodiazepine withdrawal symptoms, acute & protracted Benzodiazepine Information Coalition

Excessive doses benzodiazepine withdrawal syndrome of benzodiazepines, like alcohol, cause unsteadiness of gait, slurred speech and general incoordination, including inability to walk in a straight line. It may take some time for the cerebellar systems to restabilise after benzodiazepine withdrawal and the symptoms can last until this process is complete. Exercises, such as standing on one leg, first with eyes open, then with eyes closed, can speed recovery. Examples of slow withdrawal schedules are given at the end of this chapter.

Can one experience withdrawal even if the medication is taken as prescribed?

Additionally, medical supervision allows doctors to what is Oxford House respond much more quickly to potential side effects and withdrawal symptoms. A person’s withdrawal symptoms often depend on the half-life of the drug. Withdrawal symptoms from short-acting drugs, such as Xanax, may come on faster than withdrawal symptoms from long-acting drugs, such as Valium.

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This means that the patient, and his/her mentor, must be on the look-out for depression so that treatment, if advised by the doctor, can start early. The second drawback is that anxiety may be temporarily worsened at the start of treatment either with tricyclics or SSRIs. This is a particular risk during benzodiazepine withdrawal when anxiety levels are usually high. To avoid aggravation of anxiety, it is important to start with the lowest possible dose of an antidepressant and then work up slowly, over two or three weeks. Do not be persuaded by your doctor to start immediately on the “therapeutic” dose for depression. There are also fears that antidepressants such as Prozac may in some patients induce an agitated, violent or suicidal state at the start of treatment; low initial dosage and careful monitoring may avoid this risk.

Anxiety and related symptoms

Some people in benzodiazepine withdrawal take small doses of these drugs (10-20mg Inderal three times daily) regularly, while others reserve them to take only if the physical symptoms of a panic attack seem uncontrollable. They are not a cure, but can sometimes help people through a difficult situation. In larger doses, beta-blockers are used for raised blood pressure and angina, but such doses are not advised in benzodiazepine withdrawal. They should not be taken by anyone who has asthma as they can cause constriction of the bronchial tubes. If beta-blockers have been https://ecosoberhouse.com/ used regularly for any length of time, they should be withdrawn slowly by tapering the dosage, as they too can cause a withdrawal reaction of increased heart rate and palpitations. Improvement from the withdrawal syndromes usually occur gradually, sometimes as people taper, or slowly over the months and years after their benzodiazepine cessation.

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• Finally, your doctor may appreciate receiving some literature on benzodiazepine withdrawal, for example the articles mentioned under Further Reading at the end of Chapters 1 & 3 and of this chapter.
• Medical detoxification, under the supervision of healthcare professionals, can help manage and alleviate withdrawal symptoms.
• These symptoms can be controlled or ameliorated by beta-blocking drugs such as propranolol (Inderal).
• Diazepam (Valium) is one of the most slowly eliminated benzodiazepines.
• In fact, if you take your medication every other day, you may notice rebound symptoms on the day between doses.

However, rapid withdrawal, especially from high potency benzodiazepines, can precipitate epileptic fits as a rebound reaction. Such an occurrence is extremely rare with slowly eliminated benzodiazepines (e.g. diazepam) or with slow dosage tapering. If a fit does occur in these circumstances, it is usually only a single fit and causes no lasting damage. Other phenomena seen in rapid withdrawal are psychotic symptoms, severe confusion and delirium, but again these hardly ever occur with slow dosage tapering. By following the withdrawal schedules outlined in Chapter II, you can be confident of avoiding these complications. For short-acting benzodiazepines, such as alprazolam, rebound symptoms may appear between doses,1 which typically leads to dose escalation with temporary relief of these symptoms,4 as in this case scenario.

Possible mechanisms of persisting sensory and motor symptoms

• Short-acting drugs like Xanax (alprazolam) and Ativan (lorazepam) leave the system quicker, which means withdrawal symptoms can appear in as little as eight to 12 hours.
• Practices such as drug tapering or using other drugs to help ease withdrawal may make early withdrawal symptoms milder and more manageable.
• The severity of withdrawal symptoms varies between people and depends on a variety of factors.
• It’s incredibly important to follow your doctor’s guidance when you stop taking benzodiazepines.

Your doctor may have views on whether it is appropriate for you to stop your benzodiazepines. Some doctors, particularly in the US, believe that long-term benzodiazepines are indicated for some anxiety, panic and phobic disorders and some psychiatric conditions. However, medical opinions differ and, even if complete withdrawal is not advised, it may be beneficial to reduce the dosage or to take intermittent courses with benzodiazepine-free intervals. In rare cases, alcohol withdrawal can be life-threatening and require emergency medical intervention. Hence, it is extremely important to assess patients for alcohol dependence and monitor alcohol dependent patients carefully.