Benzodiazepines, more commonly referred to as “benzos”, are central nervous system depressants, which are generally prescribed to manage anxiety, panic disorders, and insomnia, among other things. Benzodiazepines are also sometimes used to manage alcohol withdrawal symptoms.
It is available under several brand names – Valium, Ativan, Klonopin, and Xanax. Though considered to be relatively safe when taken as prescribed, benzos can be highly addictive. After extended long-term use and abuse of benzodiazepine, the body starts to experience physical dependence and becomes unable to function without the drug. When the body doesn’t receive the drug, it goes through withdrawal.
Withdrawal symptoms range from uncomfortable to life threatening. In treatment of benzodiazepine withdrawal, it is important that medical detox is done gradually with the guidance of a medical professional. Abrupt cessation is not recommended and can result in severe benzodiazepine withdrawal symptoms. Getting professional medical care cannot be stressed enough here.
What are the symptoms of benzodiazepine withdrawal syndrome?
It is believed that the symptoms of withdrawal from benzodiazepines is more dangerous than withdrawal from opioids. Some benzo withdrawal symptoms are very similar, or even identical, to the symptoms for which a person began taking the medication in the first place. These are called rebound symptoms. Physical symptoms usually begin 24-48 hours from the time a person stops their dosage. However, it is important to note that some symptoms can take 3-4 days or even up to two weeks to show.
The most common symptoms of benzodiazepine withdrawal include:
- Panic
- Anxiety
- Sleep disturbance and fatigue
- Irritability
- Sweating
- Headache and nausea
- Insomnia
- Muscle spasms, Muscle pain and/or weakness
- Weight loss
- Poor concentration
- Sensory distortion
- Dizziness
- Heart palpitations
- Agitation
- Shaking and tremors
- Limb and extremity pain
Benzo withdrawal can have serious complications, especially for those with pre-existing conditions or a history of mental health disorder (such as anxiety disorders). These severe symptoms include:
- Seizures
- Delirium tremens (a rapid onset of confusion)
- Psychosis
- Catatonia
- Paraesthesia (shooting pains in the neck and spine)
- Mania
- Post-traumatic stress disorder
- Suicidal ideation
- Violence and aggression
Symptoms of benzo withdrawal for therapeutic doses can be bad, but the severity of withdrawal symptoms are considerably worse for those who mix benzos with prescription drugs and/or alcohol. Even some over the counter drugs or high amounts of caffeine can have bad side-effects when mixed with benzos, so it is extremely important to check with a doctor before taking anything else while on a benzodiazepine drug.
How long do symptoms last?
Typically, benzo withdrawal symptoms can last a period of 10-14 days, but it’s possible for a protracted withdrawal (post-acute withdrawal syndrome) to occur where certain symptoms last for months.
The severity of the withdrawal symptoms depends on the amount of the drug taken and how suddenly a person stops taking it. Quitting abruptly puts one at risk for more severe withdrawal symptoms. It is never recommended to quit taking benzos cold turkey; rather, one should always begin with by tapering his or her dosage as recommended by a licensed medical professional with an understanding of the patient’s history.
Some users may have prolonged (also known as protracted) withdrawal, sometimes called post-acute withdrawal syndrome. In these cases, withdrawal symptoms last for several months or even years. Common symptoms of post-acute withdrawal syndrome include chronic anxiety, depression, and sleep difficulty. The risk of developing protracted withdrawal syndrome is minimized by slowly reducing one’s dosage.
Can benzo withdrawal be fatal?
Benzodiazepine withdrawal is especially dangerous, especially when unsupervised. Psychosis, depression, and seizures may get progressively difficult to control and potentially turn lethal. Suddenly stopping taking this medication can cause a rebound effect, meaning that symptoms that were previously treated by the drug will return with greater severity. One should only stop taking any type of benzodiazepine drug under the direct supervision of a medical professional, and should follow the recommendations of the doctor exactly and precisely. A gradual reduction of dose is imperative. If a person has been using more than 50mg of a benzodiazepine drug regularly for any amount of time, or abusing any amount of the drug for an extended period of time, he or she should really begin their withdrawal process under constant supervision in inpatient care to avoid any fatal consequences. Life-threatening withdrawal symptoms can occur from going “cold turkey”.
Treatment options are available, for both the physical and the psychological symptoms. A program that includes both a medical detox process and some counseling is essential. The latter typically includes behavioral therapies such as CBT (cognitive behavioral therapy) which can help with any rebound anxiety that occurs while attacking any mental disorders that may exist, to get to the problem at its root.
A detox facility typically offers options for both an outpatient and inpatient setting. For the discontinuation of benzodiazepines, either one can work, but it’s best to discuss your needs with a professional to ensure you’re choosing the best mode of treatment for yourself. Benzodiazepine dependence doesn’t have to rule your life. Through gradual reduction of dose from medical doctors, and support from mental health professionals, it is possible to achieve the long-term recovery and quality of life you deserve.
If you or a loved one are struggling with addiction to benzodiazepine, the supportive care team at New Choices Treatment Centers can help. Our Camino Pathway Program™ provides an innovative approach to recovery, guiding you through a personalized guided journey to a better you.
Related: Psychological Dependence