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Benzodiazepines: Uses, Dangers, and Clinical Considerations PMC

But when you start removing benzodiazepines from your system, suddenly your clogged neurons become an open freeway with no traffic lanes. All those extra chemicals flood your brain, and the excess activity causes symptoms like anxiety and sweating. If you’re predisposed to seizures, your risk of having a seizure may also increase during the withdrawal period. Physical dependence on benzos can develop in as little as a few weeks after starting the use of the drug. The longer you take it, the more severe your dependence on the drug will become. Further well-designed research from other populations as well as a biologically plausible mechanism is required to confirm this association.

  1. This includes increases in excitatory neurotransmitters and hormones that produce excitation.
  2. Do not try to engage the patient in counselling or other psychological therapy at this stage.
  3. We do not receive any compensation or commission for referrals to other treatment facilities.

One study showed that replacing BZD with a 45 day captodiamine led to a decrease in severity of withdrawal symptoms in patients taking BZD for six months [70]. Additionally, during captodiamine treatment, psychomotor function improved in all areas tested from beginning to end of treatment [70]. It must be noted that these patients were taking relatively low doses of BZD pre-treatment [70]. Captodiamine is showing promise as a potential medication for the management of BZD withdrawal syndrome; however, more research needs to be performed on the side effects and safety profile of the drug. Many clinical studies have been conducted to assess the severity and treatment of withdrawal systems, while others assess more long-term effects of chronic BZD use.

How Long Do Withdrawal Symptoms Last?

Estimates suggest that 10 to 25% of people who take benzodiazepines for extended periods experience what’s known as protracted withdrawal. Withdrawing from benzodiazepines can be a difficult, even dangerous process. During the first week, you can also expect physical symptoms like headaches and hand tremors. From developing effective coping skills for substance abuse recovery 1996 to 2013, the number of people filling benzodiazepine prescriptions increased by 67%. Benzodiazepine abuse and dependence has become more significant among all age groups, from teens to elderly adults. In 2016, estimates suggest that about half a million people in the United States misused sedative drugs.

This is due to the slow tapering process of the drug, which helps prevent potentially fatal withdrawal symptoms. Research in the British Journal of Clinical Pharmacology notes that an estimated 10–25% of people who use benzos for extended periods experience withdrawal symptoms that last for 12 months or longer. Benzodiazepine, or benzo, withdrawal happens when a person suddenly stops taking benzodiazepine drugs, which doctors do not recommend.

Management of mild opioid withdrawal

Over time, tolerance develops, as the system makes adjustments to counteract the effect of benzodiazepines. Eventually, these adjustments result in neurotransmitters and other substances that exert effects in opposition to benzodiazepines being produced in more substantial amounts. This includes increases in excitatory neurotransmitters and hormones that produce excitation. Physicians will generally employ a gradual tapering schedule to reduce the likelihood and severity of withdrawal symptoms.

Patients who exhibit severe psychiatric symptoms should be referred to a hospital for appropriate assessment and treatment. People who use large amounts of stimulants, particularly methamphetamine, can develop psychotic symptoms such as paranoia, disordered thoughts and hallucinations. These symptoms can be managed using anti-psychotic medications and will usually resolve within a week of ceasing stimulant use. Withdrawal management alone is unlikely to lead to sustained abstinence from benzodiazepines.

Depending on your situation, your doctor may think it best to prescribe very small amounts of medication at a time. This will prevent you from altering the taper, but it might mean frequent trips to the pharmacy. Anyone taking them on a daily basis can develop a tolerance and dependence. 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. You may have to pause, slow down, or speed up depending on how your body reacts to withdrawal.

Benzodiazepines (benzos) are prescription drugs that treat anxiety and panic attacks. Benzo withdrawal can be a stressful process, but it is often necessary for people trying to get themselves off benzodiazepine drugs. Dependence appears to occur in a similar way to how it does with other addictive drugs. Dopamine is a type of messenger that is partly responsible for how humans feel pleasure.

Benzo Overdose Risks & Symptoms

Results showed that, compared to wild-type mice, mice on diazepam experienced longer uninterrupted sleep [42]. It also reduces the expression of mRNA transcripts such as CaMKIIa, BDNF, GIF, c-fos, NGFIa which are necessary for regulating synapses and plasticity [42]. The suppression of CaMKIIa by diazepam has a long-lasting effect leading to a limited neuronal response to changes in intracellular calcium and decreased response by GABA-A receptors [42].

4. Special Populations and Withdrawal

Offer patients opportunities to engage in meditation or other calming practices. BetterHelp can connect you to an addiction and mental health counselor. A 2018 analysis also revealed that drug misuse accounts for about 17% of benzodiazepine use among adults in the United States. Withdrawal symptoms may vary from person to person, although there are some common symptoms. By Corinne O’Keefe OsbornCorinne Osborn is an award-winning health and wellness journalist with a background in substance abuse, sexual health, and psychology.

The patient should commence psychosocial treatment as described in these guidelines. Symptomatic treatment can be used in cases where residual withdrawal symptoms persist (Table 3). Procedure for administering clonidine how psychedelic drugs can be used for mental health the new york times for moderate/severe opioid withdrawal. Patients should be monitored regularly (3-4 times daily) for symptoms and complications. The Short Opioid Withdrawal Scale (SOWS, p.37) is a useful tool for monitoring withdrawal.

Withdrawal symptoms can occur after as little as one month of use, even on small, therapeutic doses. Among people taking benzodiazepines for longer than six months, about 40% experience moderate to severe withdrawal symptoms when they quit suddenly. 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. People with benzodiazepine tolerance may take supratherapeutic doses because the recommended range no longer provides relief for their symptoms.

In some instances, benzodiazepine detox can include life-threatening withdrawal symptoms. 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). Codeine phosphate alleviates opioid withdrawal symptoms and reduces cravings. Methadone is useful for detoxification from longer acting opioids such as morphine or methadone itself.

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