Meanwhile, attention to sleep hygiene measures including avoiding tea, coffee, other stimulants or alcohol near bedtime, relaxation tapes, anxiety management techniques and physical exercise may be helpful. Taking all or most of the dose of benzodiazepine at night during the reduction period may also help. Occasionally another drug might be indicated (see section on adjuvant drugs, below). One of the symptoms that may result during benzo withdrawal is sleep disturbances. These may =https://ecosoberhouse.com/ include sleeplessness and sleep difficulties such as insomnia or strange and disturbing dreams. These sleep disturbances may last longer than 2-3 weeks, when many of the other possible symptoms peak and resolve.
Benzodiazepine Misuse
Psychological symptoms are irritability, insomnia, anxiety, depression, and memory loss. Benzodiazepines are used to treat anxiety, epilepsy, insomnia, and alcohol withdrawal. American Addiction Centers (AAC) is committed to delivering original, truthful, accurate, unbiased, and medically current information. In the first week of tapering off, your doctor may reduce your dose as much as 30% to get you to a safe amount.
Key diagnostic factors
People who are benzodiazepine dependent or at risk because of misuse should be identified and appropriately assessed to determine their risk of harm. Depending on patient characteristics, benzodiazepines can be withdrawn or the patient stabilised on a maintenance program. The choice of approach depends on an assessment of the risk of harm and relapse. Low-risk patients can be managed in general practice and may benefit most from attempting withdrawal.
Chapter 2: How to withdraw from benzodiazepines after long-term use
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 If beta-blockers have been used regularly for any length of time, they should be withdrawn slowly by tapering the dosage, as they too can cause a withdrawal reaction of increased heart rate and palpitations. Another drawback of antidepressants is that they, too, cause withdrawal reactions if they are stopped suddenly, a fact which has not always been appreciated by doctors. Antidepressant withdrawal symptoms include benzodiazepine withdrawal increased anxiety, sleep difficulties, influenza-like symptoms, gastrointestinal symptoms, irritability and tearfulness – not much different, in fact, from benzodiazepine withdrawal symptoms. These reactions can be prevented by slow tapering of the antidepressant dosage over about 1-3 months (See Table 2).
How to Taper off Benzodiazepines
- They suggest a dysfunction in motor and sensory pathways in the spinal cord and/or brain.
- Some people find alternative techniques such as aromatherapy, acupuncture or yoga helpful, but these probably act only as an aid to relaxation.
- This is probably not a good idea as it interrupts the smooth decline in benzodiazepine concentrations and also disrupts the process of learning to cope without drugs which is an essential part of the adaptation to withdrawal.
Contact your health care professional if you experience withdrawal symptoms or your medical condition worsens. Go to an emergency room drug addiction or call 911 if you have trouble breathing or other serious side effects such as seizures. In a few cases, severe palpitations, muscle tremors or motor jerks develop during benzodiazepine withdrawal and hinder progress.
To reduce the risk of acute withdrawal reactions, use a gradual taper to reduce the dosage or to discontinue benzodiazepines. When deciding whether the benefits of prescribing a benzodiazepine outweigh the risks, health care professionals should consider the patient’s condition and the other medicines being taken, and assess the risk of abuse, misuse, and addiction. Particular caution should be taken when prescribing benzodiazepines with opioids and other medicines that depress the central nervous system (CNS), which has resulted in serious side effects, including severe respiratory depression and death. Advise patients to seek immediate medical attention if they experience symptoms, such as difficulty breathing. Patients with a lower risk of relapse are those taking a daily dose of 10 mg diazepam equivalent or less at the start of tapering, and those who have made a substantial dose reduction themselves before the start of tapering. They can be life-saving in status epilepticus (repeated fits, one after another) and in fits caused by overdose of certain drugs (for example, tricyclic antidepressants).
Paying for Treatment
The social and economic consequences of chronic benzodiazepine use are summarised in Table 3 (Chapter 1). At the start of my Benzodiazepine Withdrawal Clinic in 1982, no-one had much experience in benzodiazepine withdrawal. Yet, as explained in Chapter 1, there was strong pressure from the patients themselves for help and advice on how to withdraw.
