Some supplements, such as valerian and melatonin, might also help you get some relief from your symptoms, but research has found mixed results. Your care team can offer more guidance on safely trying these supplements. After a month or so, your brain gets used to sending off more neurotransmitters just so some can get past the benzodiazepine blockade. Dependence and withdrawal can happen to anyone, even if you take your medication exactly as instructed. Psychotherapy can help you understand the root cause of your substance abuse problems. It can also help you learn to identify psychological triggers that may cause you to relapse so that you can avoid them in the future.
Management of mild alcohol withdrawal (AWS score 1-
These changes in receptors will not occur with only a single dose of a benzodiazepine. Your brain needs time to begin to function properly without the added benzo. It is very common for people to express that they have periods where they feel they are moving “one step forward and two steps back”.
Management of mild opioid withdrawal
Certain factors play a role in the severity of withdrawal symptoms, such as dosage, duration of action of the BZD duration of treatment with the drug, and severity of psychiatric symptoms pre-treatment. Studies have shown that treatment for longer periods with high-dosage, short-acting BZD contribute to more severe withdrawal effects [61]. Milder effects are seen with longer-acting BZD that are used for shorter periods [61]. Those who have never experienced withdrawal symptoms from BZD discontinuation could quit using BZD more easily [62]. Baseline anxiety is an important indicator of withdrawal symptoms [63].
- Several types of benzodiazepines are sold under popular brand names like Valium (diazepam), Xanax (alprazolam), and Klonopin (clonazepam).
- The greater the amount of opioid used by the patient the greater the dose of codeine phosphate required to control withdrawal symptoms.
- However, with this ongoing, widespread use comes the dark reality of BZD dependence [6].
- Manconi et al. explored the effects of long-term BZD use on sleep architecture and microstructure in those with insomnia.
- Common symptoms include muscular pain, sleep problems, and mood changes.
2. Side Effects of Benzodiazepine Use
Some feel it exacerbates withdrawal symptoms; others have no problem with sugar. Eating too much sugar at one time can cause a fluctuation in blood sugar. These dips in blood sugar cause levels of adrenaline and cortisol to rise, leading to symptoms like anxiety and palpitations. Many have found following a basic hypoglycemic diet helpful, limiting their intake of things like white flour and white sugar products while eating more complex carbohydrates.
Benzodiazepines: Uses, Dangers, and Clinical Considerations
Stopping benzodiazepines all at once can be dangerous, so your doctor will likely guide you through a tapering regimen that involves gradually reducing your dose over time. If you experience severe withdrawal symptoms during tapering, tell your doctor so they can adjust your care plan as needed. While they can quickly relieve symptoms of anxiety and panic, these drugs pose a high risk of dependence.
- This is because the term detoxification has many meanings and does not translate easily to languages other than English.
- Chronic use of BZD leads to a small but significant change in fluid intelligence, while long-term use of BZD correlates with worse cognitive decline when compared to the effects of using a high dosage [21].
- In their analysis of six retrospective studies, half of them showed no significant relationship between BZD use and mortality.
- A small number of respondents (3.1%) had no recollectionof whether or not they were told about benzodiazepine risks.
- They can also benefit people with conditions such as insomnia and panic attack disorder.
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 severe benzodiazepine withdrawal syndrome withdrawal. High-risk patients are best managed with initial stabilisation and maintenance therapy in specialist residential or outpatient addiction services.
ADVERSE DRUG REACTIONS
- Higher doses of benzos usually lead to more severe withdrawal symptoms.
- Off-label drug use is when a drug the Food and Drug Administration (FDA) has approved is prescribed for a purpose other than what it’s approved for.
- Captodiamine is a diphenhydramine-related compound that does not work at histamine receptors as diphenhydramine does and its mechanism of action is unclear [70].
- Other therapies, including counseling and cognitive behavioral therapy (CBT), may be helpful for people looking to manage symptoms without relying on other drugs.
- Specifically, those with cluster B personality disorders have the worst prognosis in regard to discontinuing BZD.
- This will help you come off benzos as safely as possible and reduce your risk of serious withdrawal symptoms.
Agarwal and Landon 2019 stated that the prescription of BZD in outpatient settings significantly increased from 2003 to 2015 [27]. Several studies have examined the relationship between BZD use and mortality. In a systematic review of research, Charlson et al. could not find conclusive evidence supporting increased risk of mortality in BZD users [43]. In their analysis of six retrospective studies, half of them showed no significant relationship between BZD use and mortality. One of the studies showed an increase in mortality with increased dosage and frequency of use which could be attributed to increased toxicity, another showed a positive correlation among older adults [43].
Other benzodiazepines commonly used for alcohol withdrawal include chlordiazepoxide (Librium), diazepam (Valium), and oxazepam. Descriptions of studies performed on specific treatments of benzodiazepine dependence and withdrawal symptoms. The use and discontinuation of alprazolam within 2 weeks disrupt sleep onset and quality, increasing suicide risks [51]. Researchers investigating the correlation between anxiolytic and hypnotic drugs with mortality hazards examined over 100,000 patients in a retrospective cohort study.
Medical experts continue to debate the best way to taper these medications, so there’s no single agreed-upon approach. When benzodiazepines attach to your neurons, they invite a bunch of chloride ions inside. These ions change the neuron’s electrical charge, so it has to work much harder to activate and send signals.