Benzodiazepine Withdrawal

Benzodiazepines are a group of drugs that are prescribed for both short-term and long-term treatment of a variety of medical conditions. For some of these conditions, such as seizures and sudden and severe muscle spasms, they are used only for a few hours or a few days. For other conditions, such as anxiety, sleep problems, or frequent muscle spasms or to help prevent seizures, they are used for an extended period, usually weeks or months.

Benzodiazepines work by changing the way your brain functions. Normally, chemicals in your brain called neurotransmitters send messages between your brain cells. The neurotransmitter that benzodiazepines affect is called gamma-aminobutyric acid (GABA). GABA sends out messages that have a calming effect on many of the functions of your brain. Benzodiazepines make these messages stronger and increase this calming effect.

Short-term use of benzodiazepines usually does not cause problems when you stop taking the drugs. However, if you take benzodiazepines for a long time, your body can adjust to the drug and require more of it to produce the same effect (drug tolerance). Eventually, you can develop physical dependence on benzodiazepines, which is when you experience negative effects if your dosage of benzodiazepines is reduced or stopped too quickly. These negative effects are called symptoms of withdrawal.

SYMPTOMS

Symptoms of withdrawal may begin anytime within the first 10 days after you stop taking the benzodiazepine. They can last from several weeks up to a few months but usually are the worst between the first 10 to 14 days.

The actual symptoms also vary, depending on the type of benzodiazepine you take. Possible symptoms include:

  • Anxiety.

  • Excitability.

  • Irritability.

  • Depression.

  • Mood swings.

  • Trouble sleeping.

  • Confusion.

  • Uncontrollable shaking (tremors).

  • Muscle weakness.

  • Seizures.

DIAGNOSIS

To diagnose benzodiazepine withdrawal, your caregiver will examine you for certain signs, such as:

  • Rapid heartbeat.

  • Rapid breathing.

  • Tremors.

  • High blood pressure.

  • Fever.

  • Mood changes.

Your caregiver also may ask the following questions about your use of benzodiazepines:

  • What type of benzodiazepine did you take?

  • How much did you take each day?

  • How long did you take the drug?

  • When was the last time you took the drug?

  • Do you take any other drugs?

  • Have you had alcohol recently?

  • Have you had a seizure recently?

  • Have you lost consciousness recently?

  • Have you had trouble remembering recent events?

  • Have you had a recent increase in anxiety, irritability, or trouble sleeping?

A drug test also may be administered.

TREATMENT

The treatment for benzodiazepine withdrawal can vary, depending on the type and severity of your symptoms, what type of benzodiazepine you have been taking, and how long you have been taking the benzodiazepine. Sometimes it is necessary for you to be treated in a hospital, especially if you are at risk of seizures.

Often, treatment includes a prescription for a long-acting benzodiazepine, the dosage of which is reduced slowly over a long period. This period could be several weeks or months. Eventually, your dosage will be reduced to a point that you can stop taking the drug, without experiencing withdrawal symptoms. This is called tapered withdrawal. Occasionally, minor symptoms of withdrawal continue for a few days or weeks after you have completed a tapered withdrawal.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have a seizure.

  • You develop a craving for drugs or alcohol.

  • You begin to experience symptoms of withdrawal during your tapered withdrawal.

  • You become very confused.

  • You lose consciousness.

  • You have trouble breathing.

  • You think about hurting yourself or someone else.