This is because inconsistent use doesn’t pose the same risk of dependence or withdrawal. 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. Short-acting benzodiazepines are much more likely to cause rebound symptoms.
Tapering off supratherapeutic doses
In other words, your body may rely on benzodiazepines to function if you take them frequently and for more than a short period of time. Short-acting benzodiazepines, like triazolam, pass quickly through the body, so you’ll likely experience withdrawal symptoms sooner — sometimes within a matter of hours. These factors don’t guarantee you’ll have severe withdrawal symptoms, but they can increase your vulnerability. So, your doctor may recommend a slower taper schedule as a safety precaution. In addition, over half of the survey respondents said benzodiazepines’ side effects or withdrawal symptoms caused them to consider suicide. 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.
What to Know About Benzodiazepine Withdrawal
Benzodiazepines are a powerful class of medication used to treat anxiety, insomnia, and panic disorder. Examples of benzodiazepines include alprazolam (Xanax) and diazepam (Valium). Though therapy generally can’t address withdrawal symptoms specifically, it can help improve some symptoms, like anxiety and insomnia. If you experience unpleasant withdrawal symptoms during your taper, your care team can help you explore options to address those symptoms and get relief. The 2022 survey mentioned above also asked respondents to what extent withdrawal symptoms affected their lives. They could rate each problem as nonexistent, mild, moderate, severe, quite severe, or enormous.
Short-term symptoms
In fact, if you take your medication every other day, you may notice rebound symptoms on the day between doses. It’s incredibly important to follow your doctor’s guidance when you stop taking benzodiazepines. If you stop taking them “cold turkey,” or all at once, you may experience severe, even life threatening, withdrawal symptoms. If you want to stop taking benzodiazepines after consistent long-term use, your doctor can help you gradually taper off your medication. Tapering can help take the edge off withdrawal symptoms like tremors and nausea, though it may not prevent withdrawal symptoms entirely.
Rebound symptoms
- If you experience unpleasant withdrawal symptoms during your taper, your care team can help you explore options to address those symptoms and get relief.
- 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.
- Tapering can help take the edge off withdrawal symptoms like tremors and nausea, though it may not prevent withdrawal symptoms entirely.
In most cases, your doctor will reduce your dosage by 5% to 25% in the first week. Every 1 to 4 weeks after that, they’ll reduce your dose by another 5% to 25% of the original dose. In addition to the immediate health risk, benzodiazepine withdrawal can seriously affect your quality of life. Emerging research also suggests acceptance and commitment therapy (ACT) could also have benefits during benzodiazepine withdrawal. This approach helps you learn to tolerate discomfort and distress, instead of avoiding it, and choose to live according to your values. According to the National Center for PTSD, the most beneficial kind of therapy for benzodiazepine withdrawal is cognitive behavioral therapy (CBT).
But when you start removing benzodiazepines from your system, suddenly your clogged neurons become an open freeway with no traffic lanes. All those extra chemicals flood your brain, and the excess activity causes symptoms like anxiety and sweating. They can range in severity, though for some people, they remain mild and manageable. If you’re predisposed to seizures, your risk of having a seizure may also increase during the withdrawal period.
This type of therapy can help you challenge and reframe unhelpful beliefs and behaviors and replace them with more productive ones. People tapering off the same original dosage of medication can have drastically different tapering experiences. 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. You may have to pause, slow down, or speed up depending on how your body reacts to withdrawal.
Difficult tapers
Some supplements, such as valerian and melatonin, might also help you get some relief from your symptoms, but research has found mixed results. You can call 988 to reach the Suicide and Crisis Helpline and get compassionate, confidential support severe benzodiazepine withdrawal syndrome from trained crisis counselors. 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.
