Author: James Anderson

Tapering Patients Off of Benzodiazepines

Though therapy generally can’t address withdrawal symptoms specifically, it can help improve some symptoms, like anxiety and insomnia. A therapist or other mental health professional can offer support with navigating these effects and helping improve your overall quality of life during the withdrawal period. In addition to the immediate health risk, benzodiazepine withdrawal can seriously affect your quality of life.

Respondents were 71% female,26% male, and 2% who preferred not to state their gender identity or had othergender identity. In fact, 55.9%took a benzodiazepine and at least one other of these drugs. Some people, such as those with a history of complicated withdrawal, seizures, or severe mental illness, may be better suited for an inpatient setting. This can involve living at a detox facility or hospital for several weeks, where you can receive constant medical monitoring and psychological support. There is a risk that people who quit benzodiazepines without a taper may experience a life-threatening grand mal seizure.

Tapering options were limited

Although symptoms differ from person to person, many experience withdrawal. Another thing to consider includes whether you take a long- or short-acting benzodiazepine, as withdrawal symptoms seem worse for those on high doses or short-acting benzodiazepines. 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. If you do develop physical dependence through long-term use of benzodiazepines, a doctor will likely create a tapering schedule as part of your treatment plan.

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). There are several options that can help when you are tapering off benzodiazepines. In general, these medications can help with feelings of anxiety or panic. Direct tapering is when you continue to use the same medication you have become dependent on but at lower doses over time.

How Does Tapering Off Benzodiazepines Work In Addiction Treatment?

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. A benzo taper can sometimes rid someone recovering from withdrawal symptoms. This is because tapering allows the central nervous system to adjust to the drug’s removal slowly. Over time, the medication you are substituting with is tapered down until you can safely stop it.

Because risks of continued use outweigh any potential benefits, tapering her down and off of the medication should be discussed. Protracted withdrawalsymptoms are more common than previously appreciated.8 Further research is needed to better understand how to stratify whichpatients might be at particular risk for either acute or protracted benzodiazepinewithdrawal. 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.

1. In fact, 55.9%took a benzodiazepine and at least one other of these drugs.
2. Doing so will save lives, reduce morbidity, and lessen costs to healthcare systems.
3. Benzodiazepine withdrawal can be managed with a gradual dose reduction, which will cause milder symptoms that come and go in waves.
4. This type of therapy can help you challenge and reframe unhelpful beliefs and behaviors and replace them with more productive ones.
5. Another thing to consider includes whether you take a long- or short-acting benzodiazepine, as withdrawal symptoms seem worse for those on high doses or short-acting benzodiazepines.
6. 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.

Doing so allows your body time to gradually adjust to having less and less medication in your system throughout your taper. This can help minimize withdrawal symptoms and decrease the likelihood of relapsing. Compounding pharmacies can be used to obtain very small doses near the end of the taper. When tapering off benzodiazepines, you’ll always want to work with a trained healthcare professional who can monitor you for side effects and adjust your pace accordingly. In addition, over half of the survey respondents said benzodiazepines’ side effects or withdrawal symptoms caused them to consider suicide. Short-acting benzodiazepines are much more likely to cause rebound symptoms.

Challenges of Cutting Down Your Benzodiazepine Intake

A slow tapermay help reduce the duration, number, and intensity of symptoms but does notnecessarily prevent them. Since even a gradual taper can be a difficult lifeexperience for the patient, collaboration between patient and prescriber is needed,including unbiased listening to and hearing their stories, plus individualizedcare. The adverse effects of benzodiazepines exceeded physical symptoms and sometimesinvolved negative events in the respondents’ personal, social, psychological,and professional lives. Aminority of respondents (6.1%) stated they had been ‘clearly warned’ or ‘warned, butnot sufficiently’ (7.9%). A small number of respondents (3.1%) had no recollectionof whether or not they were told about benzodiazepine risks.

The authors gratefully acknowledge the support of the Alliance for BenzodiazepineBest Practices, who helped provide funding for this study and supported the medicalwriting for this article. The authors also wish to express their gratitude toBenzodiazepine Information Coalition for its assistance in survey development anddistribution as well as review of the manuscript and contents. The authors thank Dr.Steven Wright for his review of this manuscript prior to publication. The authorsacknowledge the medical writing and editing services of Jo Ann LeQuang, whose feeswere covered by the Alliance for Benzodiazepine Best Practices. There was a great deal of criticism about clinicians, and little praise fordoctors or caregivers. A few said that their physicians ‘abandoned’ them as theystruggled to discontinue benzodiazepines.

How To Safely Taper Off Of Benzodiazepines

Buspirone provides a non-benzodiazepine option for treating these instances, and its effects are considered similar to benzodiazepines but without the potential for physical dependence. Strategies for benzodiazepine tapering can differ depending on how much and which type you take. Tapering aims to minimize withdrawal symptoms and maintain safety because stopping benzodiazepines cold turkey can result in seizures. The National Center for PTSD has issued guidance with several benzodiazepine tapering methods.

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. There are many reasons long-term benzodiazepine or Z-drug users are counseled to stop. Because of the risk of side effects in aging brains, anyone over 65 should do what they can to stop these medications.