Benzodiazepines: The Need-to-Know Series (Withdrawal (“Ouch!”))

“Well that’s odd. I ran out of Xanax a couple of days ago and I’m starting to feel kind of strange. And I can’t sleep! Wonder what’s up.”

Okay, all together now. 1-2-3…“Withdrawal!”

You know, I didn’t mean for that to come off as flippant or disrespectful. Sadly, many have no clue that the benzodiazepines (benzos) can generate dependence – and withdrawal misery.

But you knew, didn’t you? And that’s because you read Part 1 (general info) and Part 2 (dependence) of our need-to-know benzo series. (If you didn’t, just click the links).

Benzodiazepine Withdrawal

First of all, to understand benzo withdrawal you really need to be comfortable with the dynamics of benzo dependence. If you haven’t read Part 2 of the series, get after it.

So how often does a nasty benzo withdrawal occur? Well, it’s hard to say. And that’s because there are so many of them, with potency and length-of-action all over the place.

But if I had to venture a guess, I’d say just below 50% of those receiving a therapeutic benzo dose will have issues with a dose reduction or discontinuation.

Withdrawal symptoms typically arrive within three to seven days of an abrupt dosage reduction or cessation. And they can occur even if one has been taking a benzo for just three to four weeks.

“What kind of symptoms should I expect?”

The most frequently reported symptoms of benzo withdrawal are…

Insomnia, impaired perception of movement, headache, gastric issues, tremors, sweating, and muscle spams.

One may also experience agitation, irritability, derealization, depersonalization, depression, hypersensitivity to light, smell, noise, strange skin sensations, auditory/visual hallucinations, paranoid thoughts/feelings of persecution, seizures, delirium tremems (DTs), and suicidal behavior.

The more abrupt or over-rapid the withdrawal, the more prolific the symptoms!

“What’s the best way to withdraw?”

No doubt, benzo withdrawal has a nasty reputation. And that’s largely due to poor withdrawal management.

The absolute best way to withdraw from benzos is slowly and gradually – in a customized regimen. The assistance of a counselor is always helpful.

How slow and gradual? I’ve read about cases that have taken several years to resolve, and I’ve seen it happen in four weeks. Nonetheless, the recommended time frame is less than six months.

See, it all has to do with the benzo(s) being used, dose, reason for the prescription (seizures, sleep, anxiety, etc.), lifestyle, personality, environmental stressors, and available support.

By the way, I’m intentionally staying away from recommending withdrawal protocols. It’s just too dicey to handle in an article.

“Should I check-in to a hospital?”

An inpatient stay for benzo withdrawal is a good idea if you have a history of severe withdrawal symptoms – particularly psychotic features (hallucintations, persecutorial delusions) and/or seizures.

An inpatient stay may also be indicated if you’ve been taking high doses for a long period of time.

My Opinion Regarding Benzo Use for Anxiety

In presenting an opinion regarding the use of benzos for anxiety, I’m coming to you from two perspectives – a clinician and a former user.

I believe there’s a place for benzo use in the treatment of anxiety. Unfortunately, they’re prescribed too frequently – and all too often without a discussion regarding goals, alternatives, proper use, supplemental treatment, and withdrawal concerns.

There never seems to be a plan!

It’s my opinion that benzos are best used in the short-term. In the presence of crippling anxiety and agitation, they buy time – while psychotherapy and other treatment options are ramped-up and revvin’.

My greatest concern with benzo use is it removes the motivation and need to seek and refine coping strategies and techniques. I mean, why bother?

It’s a Wrap!

Well, that will do it for our need-to-know series on benzodiazepines. We’ve discussed what they are, how they work, their dependence dynamics, and withdrawal concerns.

It’s so important to have resource material like this, and our antidepressant need-to-know series, available on chipur.

And that begs the question – have any ideas for the next need-to-know series? That’s something I definitely need to know.

Why not tell me in a comment?

Oh, almost forgot! Looking for more info on benzo withdrawal? Check-out these links…

BenzoBudies: Benzodiazepine Withdrawal Suppport

Benzodiazepine Withdrawal Support