A total of 1682 individuals started the survey, of whom 1207 respondents wereidentified by the source system as having finished the survey, although some ofthese ‘finishers’ did not answer every question. In this article, ‘respondents’ isthe term used to describe these identified finishers. Respondents were 71% female,26% male, and 2% who preferred not to state their gender identity or had othergender identity. Of thefinished respondents, 1190 had taken benzodiazepines, 247 had taken a Z-drug, 167had taken antipsychotics, 222 had taken gamma-aminobutyric acid (GABA) analogues(such as the anticonvulsants gabapentin and pregabalin), and 558 had takenantidepressants.
- In cases where medication is available from the manufacturer as an oral solution, this method allows a patient to make small reductions or implement a daily microtaper.
- With tolerance, the medication’s therapeutic effect weakens, and people need to take higher and higher doses to achieve relief.
- Using an oral syringe, the patient removes an amount of liquid (measured in milliliters) from this suspension and discards it, ingesting the remainder.
- The best resource in your quest to quit benzodiazepines is your prescribing doctor.
- If you go into withdrawal without tapering, you also risk experiencing delirium and hallucinations that cause you to lose touch with reality—a terrifying and dangerous experience.
- If people develop an addiction to alcohol, illicit drugs, or the benzodiazepine itself, they may also be instructed to taper off, even if they’ve been on them long-term and still suffer from the condition that prompted them to start the treatment.
However, studies like these are important as they establish that what we do works. People wanting or needing to stop benzodiazepines can do it with appropriate help—and it may just take a handful of visits with a trained primary care provider or mental health provider. The investigators concluded that although a causality of dementia cannot be established among older individuals using benzodiazepines, there is a statistically increased risk for dementia among long-term users of these medications. In October 2015, the American Geriatrics Society (AGS) published an updated version of the Beers Criteria, which lists benzodiazepines as a potentially inappropriate medication that should be avoided in older adults [8]. In addition, over half of the survey respondents said benzodiazepines’ side effects or withdrawal symptoms caused them to consider suicide. The adverse effects of benzodiazepines exceeded physical symptoms and sometimesinvolved negative events in the respondents’ personal, social, psychological,and professional lives.
Skipping Doses
During the first week, you can also expect physical symptoms like headaches and hand tremors. In the liquid titration approach, a pill is either crushed or allowed to disintegrate in a premeasured (in milliliters) amount of milk or water to create a suspension. Using an oral syringe, the patient removes an amount of liquid (measured in milliliters) from this suspension and discards it, ingesting the remainder. Typically, 1 milliliter is removed daily, so a 300-milliliter taper would take 300 days to complete, plus any additional time for holding a dose if necessary. The underlying physical changes resulting in benzodiazepine tolerance and withdrawal are unknown. One hypothesis is that since benzodiazepines work by enhancing the neurotransmitter GABA (gamma-aminobutyric acid) at the GABA-A receptor, long-term benzodiazepine use may down-regulate GABA receptors while discontinuation may, with time, upregulate them.
What makes benzodiazepine withdrawal so dangerous?
If you’ve taken benzodiazepines at high doses for an extended period, you may experience long-term withdrawal symptoms, also called post-acute withdrawal syndrome (PAWS) or protracted withdrawal. One weakness of the study was that most of the patients included did not have other mental health comorbidities like dementia, severe psychiatric disorder, or substance use disorder, nor did most patients use other psychoactive medications. People with mental health problems may end up needing more intensive treatment, but as of now their rates of successful stopping with or without psychological support are not known. While a slow taper is recommended for ceasing benzodiazepine use,8 there is little clinical understanding of what this may involve and a paucityof guidance to navigate the process. According to the American Psychiatric Association (APA), withdrawal symptoms from short-acting benzodiazepines peak on the second day and improve by the fourth or fifth. Withdrawal symptoms can occur after as little as one month of use, even on small, therapeutic doses.
Tapering Strips
There is no perfect method guaranteed to prevent a painful withdrawal. Still, the methods mentioned here can lead many patients to a tolerable taper and maximize the patient’s chance for successful cessation and complete healing. In cases ibuprofen and alcohol: is it safe to mix otc painkillers with alcohol where medication is available from the manufacturer as an oral solution, this method allows a patient to make small reductions or implement a daily microtaper. In people with co-occurring substance use disorders, they are also very risky.
If you are pregnant or are thinking about becoming pregnant, talk to your OBGYN or psychiatrist about your plans. Your doctor can help you weigh the the difference between alcohol and ethanol potential risks and benefits of benzodiazepine use and your pregnancy. The most important thing in cessation of a benzodiazepine is patient safety.