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A Secret Weapon for Stopping Benzodiazepines Safely

todaySeptember 1, 2023

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Liquid tapering enables patients to decrease their doses gradually and at a lower reduction rate and frequency than other methods. 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. The investigators found that the risk appears unlikely for short duration of use (less than three months). A dose-effect relationship was found by several studies, with one study concluding that there was a stronger effect for medications or metabolites with a long half-life. In another study, the excess risk disappeared after one-year discontinuation in light users (less than 90 defined daily doses) but remained unchanged after a three-year discontinuation in heavy users (360 or more defined daily doses).

In some rare cases, a rapid withdrawal might be considered a lesser evil—for example, if the drug produces a paradoxical response, which happens very infrequently. While many patients who want to get off benzodiazepines have an understandable desire to withdraw from the medication as quickly as possible, rapid withdrawal is often the riskiest and most dangerous once signs of physical dependence are present. Whether patients are working closely with a prescriber or withdrawing with limited assistance, sober living homes comparison they should taper at the most comfortable rate. No patient should ever be made to taper or forced off benzodiazepines against their will. As the methods here indicate, once a patient chooses to withdraw, there are many ways to accomplish that goal without relying on rapid tapers, oversized reductions, or cold turkeys. Online support communities have developed different systems of “micro-tapering” to help reduce medication evenly throughout a taper to lessen the chance of withdrawal symptoms.

  1. These drugs mimic the effects of a neurotransmitter called gamma aminobutyric acid (GABA).
  2. In this article, ‘respondents’ isthe term used to describe these identified finishers.
  3. Although benzodiazepines and Z-drugs 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.

Over 92 million prescriptions for benzodiazepines are dispensed in the UnitedStates annually, yet little is known about the experiences of those takingand discontinuing them. 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. Anyone taking them on a daily basis can develop a tolerance and dependence. One disadvantage to this method is that most medications are not water-soluble (meaning they are not fully dissolved in water), so the resulting liquid suspension must be shaken to distribute the medication fully.

In fact, the write-in comments providedprofound insights into benzodiazepine-related adverse effects and how patients dealwith them. Several particularly relevant comments have been selected and are offeredhere. The authors identifiednine broad themes and selected relevant comments to represent each. During your taper, you may still experience some of the symptoms of withdrawal. Withdrawing from benzodiazepines can be a difficult, even dangerous process.

Recommended Taper Rate

They are an essential part of the body’s central nervous system and stress response. As a culture, we need to be careful to minimize our use and prescription of benzodiazepines and Z-drugs, using them only when absolutely necessary. Doing so will save lives, reduce morbidity, and lessen costs to healthcare systems. In severe cases, benzodiazepine and Z-drug withdrawal can be life-threatening, causing seizures and hallucinations. It’s no wonder that many people who make an attempt to stop quickly give up the fight, resigning themselves to being on them long-term.

There are fewer problems with the longer acting chlordiazepoxide and diazepam than with the shorter acting alprazolam and lorazepam. 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.

sections of the survey

Some respondents had completely discontinuedbenzodiazepines but still had symptoms, including one whose symptoms weremisdiagnosed as fibromyalgia. Many respondents had taken more than one type of benzodiazepine, whether concurrentlyor sequentially. The most frequently taken benzodiazepines were clonazepam (52.9%),alprazolam (41.7%), lorazepam (36.1%), and diazepam (32.1%). Patients wereprescribed benzodiazepines for a wide range of conditions (see Table 1).

Tapering options were limited

People tapering off the same original dosage of medication can have drastically different tapering experiences. Experiencing rebound symptoms means the symptoms you had before taking benzodiazepines come back even stronger than before. The survey link was posted for a month three different times (October 2018, November2018, and January 2019).

In addition to the immediate health risk, benzodiazepine withdrawal can seriously affect your quality of life. Read on to learn more about benzodiazepine withdrawal, including the signs, how long it lasts, and how to get support with tapering off safely. If you take benzodiazepines infrequently, such as once a week or once every few weeks to treat panic attacks, you can take them for a longer period of time. This is because inconsistent use doesn’t pose the same risk of dependence or withdrawal. Respondents were allowed to make free-form comments at the conclusion of the surveyand hundreds of comments were entered.

Surprisingly, medication-based support—with melatonin, paroxetine, and/or switching to a different benzodiazepine—was helpful in the short-term for getting people off, but did not have a significant effect at long-term follow-up compared to standard care. A variety of withdrawal schedules from several benzodiazepines are illustrated below. Schedules such as these have mdma withdrawal timeline symptoms + detox treatment options worked on real people, but you may need to adapt them for your own needs. Although there are no FDA-approved medications for the treatment of frontotemporal dementia, available data indicate that SSRIs, trazodone, and amphetamines may reduce behavioral symptoms in these individuals [21]. However, none of these medications has been shown to have an impact on cognition.

Longer-acting benzodiazepines like Klonopin (clonazepam) can stay in the system longer, which means it can be one to two days or even longer before withdrawal symptoms start. If you have been using benzodiazepines for longer than six months, suddenly stopping your dose can cause grand mal seizures and delirium—this is why it’s best to involve your doctor or healthcare professional in your withdrawal process. The primary difference between these drugs is the length of time they stay active in the body. However, benzodiazepines can cause physical dependence and withdrawal even when they are taken as directed. 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).

Medical professionals do not want to hear a long story as they are very pressed for timeb. Approach the prescriber loaded with all the knowledge you can, but keep your presentation simple and precise. Some supplements, such as valerian and melatonin, might also help you get some relief from your symptoms, but research has found mixed results. Your care team can offer more guidance on safely trying these supplements.

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. Benzodiazepines are some of the more commonly prescribed medications in the world.

Micro-tapering requires small, daily microgram reductions that add up to not more than a 5% to 10% overall reduction from the current dose each month. Daily micro-reductions may help prevent some physical and mental turmoil that larger weekly reductions can create for those very sensitive. Keeping track of dose reductions during a micro-taper usually requires a daily log or spreadsheet. Clearly, we need to know more about how to make the stopping process, also called “deprescribing,” easier.

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