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). Any Drug rehabilitation patient who has taken a benzodiazepine for longer than 3–4 weeks is likely to have withdrawal symptoms if the drug is ceased abruptly.
- Overall, benzodiazepines should be used short-term as they can lead to tolerance, abuse, dependence (addiction), withdrawal and possible fatal overdose when combined with opioids.
- As such, it is typically not advised to use benzodiazepines while pregnant or breastfeeding 1112.
- Agarwal and Landon 2019 stated that the prescription of BZD in outpatient settings significantly increased from 2003 to 2015 27.
- Lorazepam and other benzodiazepines can cause physical dependence and withdrawal symptoms, even when taken as directed.
- The main differences exist in how long they might remain in the body, possibly leading to prolonged side effects.
Benzodiazepine Withdrawal & Detox Options
Withdrawal from prescription drugs doesn’t always end when the these symptoms subside. Post-acute withdrawal syndrome (PAWS) is a collection of related symptoms, including mood swings, sleep disturbances and intense cravings that can persist for weeks or even months. Lorazepam and other benzodiazepines can cause physical dependence and withdrawal symptoms, even when taken as directed. People who are using illegal drugs or other substances should not use lorazepam.
Benzodiazepine withdrawal
Benzodiazepines are safe when taken as directed and are effective at quickly relieving panic symptoms. During inpatient rehabilitation, patients can interact with doctors, nurses, or therapists daily while living at a rehab facility. Patients may receive 24-hour care to address any co-occurring disorders or lingering withdrawal symptoms, including cravings that might persist after detox. Inpatient rehab often lasts between 30 and 45 days, but the length varies for each client.
- In one study, not a single subject diagnosed with a cluster B personality disorder successfully discontinued BZD use 63.
- The risk of inducing dependence can be reduced by issuing prescriptions limited to 1–2 weeks supply.
- The Recovery Village specializes in treatment for peoplesuffering from addiction and mental illnessand strives to find healthy alternatives to managing both disorders.
- More recent research is focusing on the possible adverse effects on cognition (thinking and reasoning ability) in patients using benzodiazepines for long periods of time.
Possible drug interactions
This is not all the information you need to know about benzodiazepines for safe and effective use and does not take the place of your doctor’s directions. Discuss any medical questions you have with your doctor or other health care provider. At all times, benzodiazepines should be discontinued under the care of a physician.
Carbolic Acid Uses On Skin For Safe Treatment
There are pharmacological options for treatment in those suffering from withdrawal or wishing to discontinue their chronic BZD use. Each of these studies received mixed results, with no statistically significant advantage to BZD therapy. The current treatment of choice is to switch the current short-acting BZD for a long-acting alternative then gradually taper the dose to wean the individual off BZD completely 8. Clonazepam has been used in the outpatient setting as a medication for taping the use of BZD. However, no set schedule benzodiazepine withdrawal for a taper has been validated in the current literature.
Regular use of BZDs has been shown to cause severe, harmful psychological and physical dependence, leading to withdrawal symptoms similar to that of alcohol withdrawal. Many drugs have been tested as a treatment for withdrawal, with few proving efficacious in randomized control trials. Future research is warranted for further exploration into alternative methods of treating BZD withdrawal. This call to action proves especially relevant, as those seeking treatment for BZD dependence and withdrawal are on the rise in the United States.
In fact, it has been observed that if taken as per prescription, there are very low chances of benzodiazepine dependence or benzodiazepine addiction. Withdrawal symptoms may be worse for short-acting benzodiazepines because your body has less time to adjust to being without them. Your doctor may change your prescription to a long-acting benzodiazepine such as clonazepam and slowly lower the dosage. They each differ in how quickly they start working (onset) and how long they take to wear off. For example, only a small dose of 0.25 milligrams (mg) of a high potency medicine has to be taken to get the intended effects.
Medications for sleep problems
Before sharing sensitive information, make sure you’re on a federal government site. Our dedicated professional staff is here to guide you or your loved one on the journey to lasting recovery, offering support every step of the way. Benzodiazepines have the advantage of taking effect quickly but are not recommended for long-term or routine use. Off-label drug use means a drug that’s approved by the Food and Drug Administration (FDA) for one purpose is used for a different purpose that has not yet been approved. Benzodiazepines are often classified by their onset of action—how quickly they begin to work after you take them.
Ongoing benzodiazepine recovery
- Withdrawal from prescription drugs doesn’t always end when the these symptoms subside.
- Some people develop a paradoxical reaction to benzodiazepines – this is the opposite reaction to what you would expect.
- Mirtazapine (Remeron) and buspirone are also effective in GAD for patients who do not respond to at least two trials of SSRIs or SNRIs.
- After the patient assessment, detoxification allows the body to remove the drugs from the system, and withdrawal symptoms begin.
Anticonvulsants have some efficacy in benzodiazepine withdrawal if the patient is not dependent on other drugs. Carbamazepine has a modest benefit12 and pregabalin can be effective.18 Antidepressants and beta blockers have no proven benefit. The benzodiazepine-dependent population is heterogeneous and this influences management. A frail 70 year old with falls prescribed flunitrazepam as a sedative hypnotic for 20 years requires a different management approach from a 25-year-old intravenous drug user buying street alprazolam. The principles of management of dependence with ‘z-drugs’ such as zolpidem and zopiclone are the same as the management of benzodiazepine dependence.
