These may be accompanied by burning pain or aches that sometimes seem to originate deep in the muscles or bones. Some people complain of an “inner trembling” or a sense of vibration, and some have described bizarre sensations as of water or slime running over the body or a serpent-like writhing on the scalp. Motor symptoms that may persist include muscle tension, weakness, cramps, jerks, spasms and shaking attacks.

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Depressive symptoms may appear for the first time after withdrawal, sometimes after a delay of a few weeks, and it can be severe and protracted for some months. It is not clear whether people who have had depression before, or have a family history of depression, are more prone to this complication, and its causes are not understood. As discussed in Chapters I and II, benzodiazepines disrupt the function of many neurotransmitters and hormones and depression could be the result, for example, of low serotonin activity combined with the stress of withdrawal. If severe enough to require definitive treatment, the depression in withdrawal responds to antidepressant drugs and/or cognitive therapy and usually diminishes gradually over 6-12 months. Withdrawal from benzodiazepines is an uncomfortable process with the potential to last for several weeks (or longer). Slow discontinuation of benzodiazepines is recommended to avoid withdrawal symptoms (eg rebound anxiety, agitation, insomnia or seizures) particularly when use exceeds 8 weeks.

Possible mechanisms of persisting sensory and motor symptoms

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. Protracted withdrawal is a long-term withdrawal syndrome that may come and go for several months. Attempts at withdrawal are more likely to succeed if the patient is able to contemplate the ultimate goal of cessation, and the doctor and patient are able to work together in a productive therapeutic relationship to achieve this.

Table 4

• However, not everyone is able to devote the mental and physical concentration required for these techniques.
• The interesting thing about these memories is that they often start to occur at the same time that vivid dreams appear; these may be delayed until one or more weeks after the dosage tapering has started.
• Drugs like Klonopin, Valium, and Librium take longer to leave the system, so the withdrawal symptom may appear a day or two after the last use.
• However, the point about gradual dosage tapering at home is that people should get used to living a normal lifestyle without drugs.
• The duration and severity of benzodiazepine withdrawal vary widely among individuals.

Group therapy allows you to develop healthy relationships with people working towards a common goal. Most symptoms start to fade within a month, but the client may still struggle with some psychological effects like anxiety. Website maintenance Halfway house is scheduled for Saturday, January 18, and Sunday, January 19. Patients with cognitive impairments as a result of alcohol dependence should be provided with ongoing vitamin B1 (thiamine) supplements.

• Specializing in residential treatment and drug and alcohol detoxification, we offer a holistic and comprehensive approach to recovery.
• This is because the term detoxification has many meanings and does not translate easily to languages other than English.
• This helps to relieve benzodiazepine withdrawal symptoms and prevent the development of seizures.
• Sometimes the other person’s face will appear when looking in the mirror.
• If sleep is really a problem, a small dose of a tricyclic antidepressant with sedative effects (see antidepressants, above) is a possible option.
• The classic six weeks withdrawal period adopted by many clinics and doctors is much too fast for many long-term users.

To avoid aggravation of anxiety, it is important to start with the lowest possible dose of an antidepressant and then work up slowly, over two or three weeks. Do not be persuaded by your doctor to start immediately on the “therapeutic” dose for depression. There are also fears that antidepressants such as Prozac may in some patients induce an agitated, violent or suicidal state at the start of treatment; low initial dosage and careful monitoring may avoid this risk. Depressive symptoms are common both during long-term benzodiazepine use and in withdrawal. It is not surprising that some patients feel depressed considering the amalgam of other psychological and physical symptoms that may assail them.

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Probably many factors are involved, some directly due to the drug and some to indirect or secondary effects (See Table 4). Some drugs related to major tranquillisers have sedative effects and are also used for nausea, vertigo and motion sickness. These are sometimes prescribed during withdrawal, especially prochlorperazine (Compazine). However, such drugs can have serious side effects (motor disorders like Parkinson’s disease) and are not recommended for long-term use or as a substitute for benzodiazepines. Benzodiazepines undoubtedly have effects on the endocrine system, but these have not been closely studied in humans, either during long-term benzodiazepine use or in withdrawal.

• When benzodiazepines are taken for a prolonged period, the brain adjusts its chemistry to accommodate the continuous influx of the drug.
• These substances may help people regain their physical health and lessen withdrawal symptoms.
• Doctors may use certainmedications to manage drug cravingsand withdrawal symptoms during medical detox.
• Many people have suffered because they have been switched suddenly to a different, less potent drug in inadequate dosage because the doctor has not adequately considered this factor.

Additional studies would be beneficial to determine the safety and efficacy of phenobarbital and establish optimal dosing and weaning protocols in the outpatient setting. For short-acting benzodiazepines, such as alprazolam, rebound symptoms may appear https://ecosoberhouse.com/ between doses,1 which typically leads to dose escalation with temporary relief of these symptoms,4 as in this case scenario. This patient has developed numerous concerning adverse effects, including tolerance, physiologic dependence, and withdrawal.

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The drug helps the user achieve a state of relaxation, which reduces anxiety. Benzodiazepines affect the brain’s natural reward system when taken for long periods of time. It increases dopamine production, which creates a temporary state of calmness and contentment. This reduces the neurotransmitters the brain naturally produces, so you become reliant on the drug to feel normal. Using this simple protocol, short-acting benzodiazepines can be safely discontinued. There is some evidence that lithium carbonate may be an effective medication for cannabis withdrawal management.

The choice of, and response to, each of these measures depends very much on the individual. The various psychological techniques have been formally tested and give the best long-term results. However, the outcome depends largely on the skill of the therapist, including his/her knowledge of benzodiazepines, and the rapport between therapist and client. Besides detox, you need a comprehensive treatment plan to address addiction’s psychological benzodiazepine withdrawal aspects and break the drug use cycle. Consider partial hospitalization if you still need high-level care but wouldn’t wish to reside at the treatment facility.