Benzodiazepine withdrawal syndrome
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| Benzodiazepine withdrawal syndrome | |
|---|---|
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| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Anxiety, insomnia, seizures, tremors, muscle pain, sweating, nausea, vomiting, hallucinations, delirium |
| Complications | Seizures, delirium tremens, psychosis |
| Onset | Within hours to days after reducing or stopping benzodiazepines |
| Duration | Weeks to months |
| Types | Acute withdrawal, protracted withdrawal |
| Causes | Discontinuation or reduction of benzodiazepines |
| Risks | Long-term use, high doses, rapid tapering |
| Diagnosis | Clinical evaluation |
| Differential diagnosis | Alcohol withdrawal syndrome, barbiturate withdrawal, opioid withdrawal |
| Prevention | Gradual tapering of benzodiazepines |
| Treatment | Benzodiazepine tapering, supportive care, psychotherapy |
| Medication | Benzodiazepines, anticonvulsants, antidepressants |
| Prognosis | Generally good with proper management |
| Frequency | Common in long-term benzodiazepine users |
| Deaths | N/A |
Benzodiazepine withdrawal syndrome, often abbreviated to benzo withdrawal or BZD withdrawal, describes the cluster of signs and symptoms that emerge when an individual, who has developed a physical dependence on benzodiazepines, undergoes dosage reduction or discontinuation. This can occur in individuals who have been taking the medication either medically or recreationally.
Development of Dependence and Withdrawal Symptoms
Physical dependence on benzodiazepines can result from taking the medication as prescribed, and the resulting withdrawal symptoms can sometimes last for years. The onset and duration of the withdrawal syndrome largely depends on the half-life of the drug, with withdrawal from short-acting drugs tending to begin earlier and progress more quickly than withdrawal from long-acting drugs.
Characteristics of Benzodiazepine Withdrawal
The withdrawal syndrome is typically characterized by:
- Sleep disturbances
- Irritability
- Increased tension and anxiety
- Panic attacks
- Hand tremor
- Shaking
- Sweating
- Difficulty with concentration
- Cognitive difficulties
- Memory problems
- Dry retching and nausea
- Weight loss
- Palpitations
- Headaches
- Muscular pain and stiffness
This constellation of symptoms can produce significant distress and impairment in daily functioning.
Treatment
It is generally recommended that the dosage of the benzodiazepine be reduced gradually, as abrupt withdrawal from the drug can lead to severe and potentially dangerous withdrawal symptoms, including seizures. This process should be carried out under medical supervision. Several types of medication may be used to manage withdrawal symptoms. For example, antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), may be used to manage the increased anxiety and mood disturbances associated with withdrawal.
Prognosis
With appropriate management, the prognosis for benzodiazepine withdrawal is generally good. Most individuals are able to successfully discontinue the drug and manage their withdrawal symptoms with medical assistance. However, some individuals may experience protracted withdrawal symptoms that can last for months or even years.
See Also
- Benzodiazepine
- Substance dependence
- Substance withdrawal syndrome
- Alcohol withdrawal syndrome
- Opioid withdrawal syndrome
References
- Ashton H. (2002). "Benzodiazepines: How they work and how to withdraw". The Ashton Manual. Retrieved 2021-09-01.
- Lader M. (2011). "Benzodiazepines revisited—will we ever learn?". Addiction, 106(12), 2086-2109. doi:10.1111/j.1360-0443.2011.03563.x
External Links
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Contributors: Prab R. Tumpati, MD
