Based on the experience of missed doses, people on benzodiazepines will often know whether they are likely to have a problem. There is an acute withdrawal syndrome that is managed by tapering and a protracted withdrawal syndrome that at present has no treatment. Eight of the 10 studies included in this review showed an increased risk of dementia in benzodiazepine users by a factor of 1.24 to 2.30.
- Respondents were self-selected,forming a convenience sample that may not represent the population of benzodiazepineusers as a whole because visitors may have sought sites such as these specificallybecause they have experienced problems.
- Most prescribing guidelines recommend against using benzodiazepines for more than two to four weeks consecutively.
- It would be important to identify this group as well asthose for whom withdrawal is difficult; the latter need specialists to treatthem, but not the former.
Lorazepam (Ativan), diazepam (Valium) and alprazolam (Xanax) are examples of medications classified as benzodiazepines. Z-drugs are similar in their pharmacology—they also bind to and activate the brain’s benzodiazepine receptors±and include zolpidem (Ambien) and eszopiclone (Lunesta). The general guideline is to not exceed a 5% to 10% reduction of the current dose every four weeks. One study found that a “tapering” method used by many physicians—to reduce a benzodiazepine dose by 25% a week—was ineffective for at least 32% to 42% (that is, they failed to get off the drug).
Despite the lack of evidence on the long-term effectiveness of benzodiazepines and their potential harmful effects, prescriptions of the drug have significantly increased in the US over the past decade. This article reviews best practices regarding primary care benzodiazepine prescriptions and how providers can best prevent and treat benzodiazepine use disorder and other harmful effects. The study reported on ‘suicidal thoughts’, whichcan https://sober-house.org/ range from fleeting notions of self-harm to passive desperation, preparatoryplanning, and disinhibition. Suicidal thoughts may be underreported, even in ananonymous online survey, as respondents might hesitate or be embarrassed to reportself-destructive thoughts. The large number ofwrite-in comments suggests that many respondents felt the survey did not allow themto fully describe the extent of their experiences and emotions.
Recommended Taper Rate
Benzodiazepines, a class of medication known as anxiolytics, are listed as Schedule IV controlled substances. They are often prescribed for conditions such as anxiety, insomnia, seizures, and alcohol withdrawal, but are also given for a vast array of off-label uses such as restless leg syndrome, muscle spasms, tinnitus, dementia, mania, and akathisia. Commonly prescribed benzodiazepines include Klonopin (clonazepam), Ativan (lorazepam), Xanax (alprazolam), Valium (diazepam), Onfi (clobazam), Tranxene (clorazepate dipotassium) and Librium (chlordiazepoxide). Most prescribing guidelines recommend against using benzodiazepines for more than two to four weeks consecutively. While estimates vary, and we don’t know the exact number, a large percentage of patients prescribed benzodiazepines long-term (more than two to four weeks) will develop physical dependence and have problems safely stopping the medications.
Consequently, experts recommend you take benzodiazepines for no more than 2 weeks if you use them daily. If you only use them once every few days, you may be able to take them for up to 4 weeks. Tapering weans the body off a benzodiazepine slowly to create a more manageable withdrawal process.
Common Benzodiazepine Side Effects
Approach the prescriber loaded with all the knowledge you can, but keep your presentation simple and precise. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. When benzodiazepines attach to your neurons, they invite a bunch of chloride ions inside. These ions change the neuron’s electrical charge, so it has to work much harder to activate and send signals. For some people, yes, it can be an emergency, especially in people prone to seizures.
For example, say you’re tapering off a dose of 20 milligrams (mg) of diazepam (Valium). A very quick taper would involve reducing the dose by 5 mg (25%) each week. Benzodiazepines have a sedative effect because of how they work in your brain. These drugs mimic the effects of a neurotransmitter called gamma aminobutyric acid (GABA).
Substitute Tapering
Common side effects include slurred speech, memory loss, confusion, sleepiness, and increased fall risk. If people become tolerant, and as the dose is increased to get more therapeutic benefit, the side effects get worse, too. Some people even start to crave these medications and use more than prescribed or develop an addiction to them. Although benzodiazepines and Z-drugs ketamine detox are useful therapeutic agents, often prescribed for sleep disorders, muscle spasms, anxiety, and seizure, they are ideally used only on a short-term basis because they are notoriously habit-forming. Unfortunately, many people end up on them long-term—up to 15 percent of people, studies say. Benzodiazepine withdrawal is typically grouped into three distinct phases.
Short-term symptoms
Studies show that brief discussions with older patients about the adverse effects of benzodiazepines and how best to taper the medications can decrease use by close to 50 percent. If you take an intermediate-acting benzodiazepine, like alprazolam, or a long-acting benzodiazepine, like diazepam, it may take longer for withdrawal symptoms to appear. Short-acting benzodiazepines, like triazolam, pass quickly through the body, so you’ll likely experience withdrawal symptoms sooner — sometimes within a matter of hours.