If symptoms are not sufficiently controlled either reduce the dose of methadone more slowly, or provide symptomatic treatment (see Table 3). Benzodiazepine, or benzo, withdrawal happens when a person suddenly stops taking benzodiazepine drugs, which doctors do not recommend. The withdrawal symptoms, which vary in severity, typically begin within 24 hours and may last from a few days to a few months. Short-acting benzodiazepines, like triazolam, pass quickly through the body, so you’ll likely experience withdrawal symptoms sooner — sometimes within a matter of hours. Table 1 presents the baseline characteristics of the patient cohort based on their medication group.
Early Stage (First Few Days)
However, this study was limited by a small sample size, so further randomized clinical trials need to be conducted to assess the efficacy of gabapentin treatment in BZD -dependent MMT patients [68]. Further studies need to be performed on not just gabapentin, but other medications for MMT patients with BZD dependence should be evaluated since treating them is more complicated. 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.
Management of benzodiazepine withdrawal
This should be taken into consideration in planning treatment involvement. Patients with cognitive impairments as a result of alcohol dependence should be provided with ongoing vitamin B1 (thiamine) supplements. Provide symptomatic treatment (see Table 3) and supportive care as required.
3. Alprazolam
This was further supported by data from Rooney et al. which reported that 54% of abusers of oxycodone are also dependent on a BZD [45]. The study benzodiazepine withdrawal also showed that 64% of heroin users are also abusing BZD [46]. There has been a steady increase in the number of prescribed BZDs in the US [27].
- Additionally, in this study, approximately 80% of patients experience withdrawal symptoms, which is much greater than the rate in other studies [65].
- Given concerns for use dependence and withdrawal, SSRIs and antidepressants have been made mainstay therapy for these conditions.
- Other studies have assessed different methods of counseling on BZD dangers and alternatives to patients alongside a gradual taper off the drugs.
- Anxiety, stress, or other mental health disorders can exacerbate withdrawal symptoms and prolong the timeline.
- Having other health conditions alongside benzodiazepine use can impact withdrawal.
- It is very common for people who complete withdrawal management to relapse to drug use.
According to the classification, these drugs have a low potential for abuse and low risk of dependence. Withdrawal symptoms may be mild in people who take the drugs for short periods. However, there is still a possibility of severe reactions and withdrawal symptoms. A person’s withdrawal symptoms often depend on the half-life of the drug. Withdrawal symptoms from short-acting drugs, such as Xanax, may come on faster than withdrawal symptoms from long-acting drugs, such as Valium. People looking to get off benzos should do so under the guidance of a healthcare professional, who may recommend coping strategies and other tools to make the withdrawal process more comfortable.
In one study, not a single subject diagnosed with a cluster B personality disorder successfully discontinued BZD use [63]. Additionally, younger patients tend to have a decreased success rate of discontinuing BZD use than older patients [66]. Interestingly, those who used alcohol while taking BZD experienced no difference in discontinuation rate from those who did not use alcohol [64]. The beta-blocker propranolol has shown mixed results when it comes to treating BZD withdrawal and dependence. One study found that propranolol attenuated some withdrawal symptoms in patients who stopped taking either diazepam (a long-acting BZD) and those who took lorazepam (a short-acting one) abruptly [69].
What are the treatments for managing benzo withdrawal symptoms?
The gabapentin and benzodiazepine treatment group included patients who were initiated on benzodiazepines for AW according to the CIWA protocol along with gabapentin. To be included in this group, patients had to receive at least 900 mg of gabapentin on day 1 or an average of 900 mg or more/day over their stay. Lower dosages were excluded in accordance with the existing literature, which has used a dose limit higher than 900 mg daily on average for the entire course of treatment [2,9,10,11,12,13]. The benzodiazepines-only group included patients who received benzodiazepines but did not receive any dosage of gabapentin for AW management or any other reasons. The study reported on ‘suicidal thoughts’, whichcan range from fleeting notions of self-harm to passive desperation, preparatoryplanning, and disinhibition.
- In a survey of British general practitioners, many reported pressures in prescribing BZD to patients and a lack of adequate knowledge on alternative psychological treatment for insomnia [41].
- However, methadone may be used if the primary diagnosis is a medical condition and the secondary condition is withdrawal from opiates.
- This was compared to a gradual taper without the other components of the treatment plan [72].
- The usual initial dosage of diazepam or lorazepam is titrated according to elevations of blood pressure, pulse rate, degree of agitation and presence of delirium.
- Dizziness is often reported as being the withdrawal symptom that lasts the longest.
- The greater the amount of opioid used by the patient the greater the dose of codeine phosphate required to control withdrawal symptoms.
Respondents were 71% female,26% male, and 2% who preferred not to state their gender identity or had othergender identity. In fact, 55.9%took a benzodiazepine and at least one other of these drugs. The use and discontinuation of https://ecosoberhouse.com/ alprazolam within 2 weeks disrupt sleep onset and quality, increasing suicide risks [51]. Other important indications for the use of BZDs include the treatment of catatonia, seizure disorders, and alcohol and BZD withdrawal.
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]. People with severe anxiety before starting treatment with BZD typically have more severe withdrawal symptoms, and thus have a harder time fully discontinuing the drug [63]. Psychiatric diagnoses have also been linked to one’s ability to discontinue treatment with BZD. One study showed a high co-occurrence with BZD dependence and all psychiatric disorders in general [64,65]. Specifically, those with cluster B personality disorders have the worst prognosis in regard to discontinuing BZD.