Benzodiazepines: Uses, Dangers, and Clinical Considerations PMC

These ions change the neuron’s electrical charge, so it has to work much harder to activate and send signals. Benzodiazepines have a sedative effect because of how they work in your brain. These drugs mimic the effects of a neurotransmitter called gamma aminobutyric benzodiazepine withdrawal acid (GABA). GABA acts as a sort of speed bump that helps all the other chemical messengers travel through your brain at a reasonable pace. Among respondents whose symptoms lasted months or years, over half said caffeine or alcohol worsened their PAWS symptoms.

What happens when you stop taking benzodiazepines?

Many instances of benzodiazepine withdrawal have resulted in serious, life-threatening complications. Seizures, specifically grand mal seizures, are potential when a benzodiazepine is abruptly eliminated from daily use. A symptom, such as a seizure, can arise very quickly and without notice. This is why we recommend that you seek immediate medical attention BEFORE you decide to quit taking a benzodiazepine whether it has been prescribed or you are taking it due to an addiction.

• Patients should drink at least 2-3 litres of water per day during stimulant withdrawal.
• During withdrawal some patients may become disruptive and difficult to manage.
• Shorter-acting preparations such as lorazepam are indicated when elimination time for benzodiazepines is prolonged, such as in patients with significant liver disease.
• Methadone is useful for detoxification from longer acting opioids such as morphine or methadone itself.

Benzodiazepines: Uses, Dangers, and Clinical Considerations

Those who have never experienced withdrawal symptoms from BZD discontinuation could quit using BZD more easily [62]. People with severe anxiety before starting treatment with BZD typically have more severe withdrawal symptoms, and thus have a harder time fully discontinuing the drug [63]. Psychiatric diagnoses have also been linked to one’s ability to discontinue treatment with BZD. One study showed a high co-occurrence with BZD dependence and all psychiatric disorders in general [64,65].

4. Complications of Benzodiazepine Abuse

Benzo withdrawals can be severe, and life threatening complications can occur. A healthcare professional should supervise benzo withdrawal to help monitor and manage the symptoms. Research in the British Journal of Clinical Pharmacology notes that an estimated 10–25% of people who use benzos for extended periods experience withdrawal symptoms that last for 12 months or longer. Short-acting benzodiazepines are much more likely to cause rebound symptoms. In fact, if you take your medication every other day, you may notice rebound symptoms on the day between doses.

Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.

This helps to relieve benzodiazepine withdrawal symptoms and prevent the development of seizures. The dose of buprenorphine given must be reviewed on daily basis and adjusted based upon how well the symptoms are controlled and the presence of side effects. The greater the amount of opioid used by the patient, the larger the dose of buprenorphine required to control symptoms. Symptoms that are not satisfactorily reduced by buprenorphine can be managed with symptomatic treatment as required (see Table 3). These factors don’t guarantee you’ll have severe withdrawal symptoms, but they can increase your vulnerability. So, your doctor may recommend a slower taper schedule as a safety precaution.

When used appropriately they are very effective in treating these disorders. However, when used for an extended period of time (e.g. several weeks), dependence can develop. To avoid the risk of overdose in the first days of treatment methadone https://ecosoberhouse.com/ can be given in divided doses, for example, give 30mg in two doses of 15mg morning and evening. Opioids are drugs such as heroin, opium, morphine, codeine and methadone. Opioid withdrawal can be very uncomfortable and difficult for the patient.

Treatment Approaches and Effectiveness

A taper over eight to 12 weeks or longer may be indicated in patients who have been taking benzodiazepines for several years (Table 5). The rate of taper is a reduction in dosage of approximately 25 percent per quarter of the withdrawal period (e.g., 25 percent per week for one month). There are no standard tapering regimens and the rate of tapering depends on the starting dose, duration of therapy, risk of relapse and how well tapering is tolerated by the patient. In general, at higher doses (e.g. greater than 10 mg diazepam equivalents per day) the dose may be tapered more rapidly. Once the patient achieves 10 mg the dose should be tapered more slowly (e.g. 5 mg twice daily for two weeks, then once daily for two weeks, and then 2 mg daily for two weeks and then cease).

• Their sedative effect aids in sleep and insomnia disorders by reducing sleep onset latency.
• Practices such as drug tapering or using other drugs to help ease withdrawal may make early withdrawal symptoms milder and more manageable.
• A patient’s score on the AWS should be used to select an appropriate management plan from below.
• The mainstay of BZD withdrawal treatment at this time is a slow taper off the drug to prevent severe withdrawal symptoms; however, many patients cannot tolerate this taper without experiencing rebound anxiety and other symptoms.

1. Indications for Benzodiazepines