If you are pregnant or are thinking about becoming pregnant, talk to your OBGYN or psychiatrist about your plans. However, going through any withdrawal during pregnancy also has its risks. Your doctor can help you weigh the potential risks and benefits of benzodiazepine use and your pregnancy.
Management of benzodiazepine withdrawal
Rapid removal of the drug opens the floodgates, resulting in rebound overactivity of all the systems which have been damped down by the benzodiazepine and are now no longer opposed. Although there is no specific tapering schedule https://ecosoberhouse.com/ to follow, the doctor may reduce the initial dose by 25% after every two weeks until the lowest possible amount. Alternatively, they can cut the daily dose by 25% in the first week, then lower it further by 25% in the second week, then by 10% in the following weeks until discontinuation. You might still experience withdrawal symptoms, but your doctor can slow down or pause the taper if the effects become intolerable.
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- The client learns to recognize unhealthy behaviors, thoughts, and emotions to help avoid and manage triggers.
- Some people during benzodiazepine withdrawal report feeling unsteady on their feet; sometimes they feel they are being pushed to one side or feel giddy, as if things were going round and round.
- Your doctor will develop an effective treatment plan to flush the toxins out of your body with minimal discomfort.
- The symptoms were improved by percent and the greatest response occurred in patients with the lowest anxiety ratings.
- Although these drugs vary in their effects, they have similar withdrawal syndromes.
- It was prescribed by another physician who had since retired, and she insisted that it was the only thing that helped her symptoms.
It is difficult to imagine that such concentrations would be sufficient to produce clinical effects or that any direct effects could last for months or years. However, it is not inconceivable that even low concentrations might be enough to prevent the return of GABA/benzodiazepine receptors in the brain to their pre-benzodiazepine state. If so, the receptors would continue to be resistant to the natural calming actions of GABA (See Chapter I), and the effect could be to prolong the state of nervous system hyperexcitability. Possible factors contributing to protracted symptoms are outlined in Table 4.
Tapering dosing
All opioid dependent patients benzodiazepine withdrawal who have withdrawn from opioids should be advised that they are at increased risk of overdose due to reduced opioid tolerance. Should they use opioids, they must use a smaller amount than usual to reduce the risk of overdose. Opioids are drugs such as heroin, opium, morphine, codeine and methadone.
Once started on an antidepressant for depression, the treatment should be continued for some months (usually about 6 months) to avoid recurrence of the depression. Benzodiazepine tapering can continue during this time, and the antidepressant will sometimes act as a welcome umbrella during the last stages of withdrawal. It is important to finish the benzodiazepine withdrawal before starting to withdraw the antidepressant. Quite often, people taking long-term benzodiazepines are already taking an antidepressant as well. In this case they should stay on the antidepressant until the benzodiazepine withdrawal is complete.
- Probably many factors are involved, some directly due to the drug and some to indirect or secondary effects (See Table 4).
- However, until further research has established the efficacy of the medication for this purpose, it is not recommended for use in closed settings.
- The primary difference between these drugs is the length of time they stay active in the body.
- However, with the right support and guidance, recovery and a life free from dependence on benzodiazepines are entirely attainable.
The severity of withdrawal symptoms varies between people and depends on a variety of factors. There is absolutely no doubt that anyone withdrawing from long-term benzodiazepines must reduce the dosage slowly. Abrupt or over-rapid withdrawal, especially from high dosage, can give rise to severe symptoms (convulsions, psychotic reactions, acute anxiety states) and may increase the risk of protracted withdrawal symptoms (see Chapter 3). Slow withdrawal means tapering dosage gradually, usually over a period of some months. The aim is to obtain a smooth, steady and slow decline in blood and tissue concentrations of benzodiazepines so that the natural systems in the brain can recover their normal state. As explained in Chapter 1, long-term benzodiazepines take over many of the functions of the body’s natural tranquilliser system, mediated by the neurotransmitter GABA.
During the early stages of withdrawal, the person may notice the symptoms of the condition that the drug was treating start to return, or rebound. For example, symptoms of anxiety or insomnia may come back or get worse without the drugs. There are three possible phases for benzo withdrawals, each with an estimated timeline. A person should always withdraw from benzos under the guidance of a healthcare professional. They should never quit benzos suddenly without first consulting a professional and developing a plan with them.
- When benzodiazepines attach to your neurons, they invite a bunch of chloride ions inside.
- This is due to the development of drug tolerance (Chapter I) which sometimes leads doctors to increase the dosage or add another benzodiazepine.
- Many of these trials have involved what is considered here as over-rapid withdrawal.
- In 2016, estimates suggest that about half a million people in the United States misused sedative drugs.
- Many people taking benzodiazepines long-term have also been prescribed antidepressant drugs because of developing depression, either during chronic use or during withdrawal.
The benzodiazepine withdrawal treatment guidelines at The Recovery Village allow some patients to be treated with medications. Drug rehabilitation There has been increasing interest in the question of diet in benzodiazepine withdrawal, particularly in North America. Some people advise that caffeine and alcohol should be completely ruled out. However, the point about gradual dosage tapering at home is that people should get used to living a normal lifestyle without drugs. Clearly one should not take caffeine late in the evening or drink cups of tea/coffee (unless decaffeinated) in the middle of the night if insomniac, but to prohibit a cup of tea/coffee at breakfast is in general unduly restrictive.
Support BIC
The first step in benzodiazepine withdrawal management is to stabilise the patient on an appropriate dose of diazepam. Calculate how much diazepam is equivalent to the dose of benzodiazepine that the patient currently uses, to a maximum of 40mg of diazepam (Table 8). The safest way to manage benzodiazepine withdrawal is to give benzodiazepines in gradually decreasing amounts. This helps to relieve benzodiazepine withdrawal symptoms and prevent the development of seizures. Navigating the complexities of benzodiazepine withdrawal is not a journey anyone should take alone.