Benzo Withdrawal

Define Benzodiazepine

Benzodiazepines (benzos) are a class of nervous system depressants used to treat insomnia (sleeping problems) and anxiety disorders. Long-term usage of benzos can cause addiction and lead to dependence. There are different examples of benzodiazepines that are different in potency and duration of action. Examples are Alprazolam (Xanax), diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), etc.

Benzodiazepine withdrawal syndrome

Abrupt discontinuation of the benzos after a long period of use may precipitate benzodiazepine withdrawal syndromes. Benzodiazepine withdrawal syndromes are a group of signs and symptoms observed after long-term use of benzodiazepine either medically or recreationally and has developed physical dependence. The severity of symptoms can range from mild to life-threatening. Consequently, the American Addiction Centres have shed light on Xanax withdrawal symptoms low dose, symptoms of Ativan withdrawal, withdrawal symptoms from lorazepam, and clonazepam withdrawal symptoms list. Also, reading through the direct life experience of Klonopin withdrawal symptoms Reddit will hasten the need to be self-informed on what the benzos withdrawal symptoms are and how better to manage them. This article seeks to explain what benzodiazepine withdrawal syndrome is and how you should prevent, manage, or treat it.

Benzo Withdrawal Risk Factors

Benzodiazepine withdrawal, like other addictive medications, occurs via the dopamine pathway. The euphoric sensation associated with the usage of benzodiazepine medications is due to an increase in dopamine levels in the brain. Therefore, withdrawal symptoms set in when dopamine levels in the brain drop abruptly due to the discontinuation of the medication.

The severity and how long the benzodiazepine withdrawal syndromes last are subject to the following factors:

  • The dose being taken before the discontinuation
  • The duration of treatment with the medication
  • The specific example of benzos medication being used
  • Co-administration with other benzos
  • Co-morbidity with other mental conditions
  • Co-administration with other sedating drugs
  • The discontinuation approach

Benzodiazepine Withdrawal Signs and Symptoms

Even if you strictly follow the prescription, benzodiazepine withdrawal symptoms appear after a lengthy period of usage, such as 3–6 weeks. The longer the duration of treatment, the more likely benzodiazepine dependence and a thus higher chance of withdrawal symptoms upon abrupt discontinuation.

The onset of the withdrawal symptoms and how long do benzo withdrawal symptoms last are factors of the duration of action of the benzodiazepines you are taking. For example, according to American Psychiatric Association (APA), withdrawal symptoms from short-acting benzodiazepines like alprazolam (Xanax) and lorazepam (Ativan) peak on the second day and ease by the fourth or fifth day while long-acting clonazepam (Klonopin) and diazepam (valium) could take few weeks or months.

Signs and symptoms of benzodiazepine withdrawal include:

  • Anxiety
  • Insomnia
  • Irritability
  • Restlessness
  • Hand tremors
  • Muscle spasms
  • Headache
  • Sweating
  • Racing pulse
  • Hyperventilation
  • Nausea or vomiting
  • Aches and pains
  • Hypersensitivity to stimuli like light and touch
  • Abnormal bodily sensations (skin-crawling, goosebumps)
  • Depression
  • Problems with concentration and memory
  • Visual disturbances (flashes of light or blurred vision)
  • Auditory, tactile, or visual hallucinations
  • Feelings of unreality
  • Delirium
  • Grand mal seizures

Benzo Withdrawal Timeline

There are three different phases of benzo withdrawals syndrome’s timeline.

  1. Early or initial withdrawal: During the immediate withdrawal phase, you may experience the same symptoms as the ailment you’re treating (shortly after stopping the drug). The time it takes for you to experience the rebounds depends on the duration of action of the benzodiazepine in question. It is not suggested that you discontinue taking benzodiazepines without consulting your doctor. Your doctor will taper down the dose before discontinuation.
  2. Acute withdrawal: Acute withdrawal syndrome is the most challenging period as said by people who have experienced it. Acute withdrawal syndrome starts a few days following the initial withdrawal syndrome and can persist anywhere from 5 to 28 days or more. Other medications may be offered to help manage the symptoms during this time.
  3. Protracted withdrawal: Protracted withdrawal describes symptoms that persist after the acute withdrawal period has passed. In 10 to 15% of people who use benzodiazepines for a long time, withdrawal symptoms can extend up to 12 months, according to the British Journal of Clinical Pharmacology. Insomnia, anxiety, poor concentration, a decrease in sexual desire, melancholy, and mood swings are all indications of protracted withdrawal symptoms (PAWS).

Coping With Benzodiazepine Withdrawal

Tapering off benzodiazepines is the easiest way to stop using them without experiencing severe withdrawal symptoms. The method entails gradually reducing the dosage for weeks or months.

You can taper down on your own, but it’s best to do so with the help of your healthcare provider. This is referred to as medical detoxification. Before tapering, your doctor may need to switch you to a new drug. Withdrawal of short-acting benzodiazepines is notoriously more difficult than long-acting ones.

In addition, you may be prescribed various drugs as well as cognitive behavioral therapy, mindfulness training, and exercise to help you deal with withdrawal syndrome. Flumazenil (Romazicon) and buspirone are examples of drugs that are used to manage withdrawal syndrome.

Benzodiazepine Withdrawal Warnings

It is important to underscore that you should not stop using benzodiazepines suddenly. Doing so can cause delirium and grand mal seizures, both of which can be fatal. As a result of this, people having a history of withdrawal, seizure, or psychiatric disorder should be tapered down as inpatients. Quitting benzos abruptly can aggravate the psychiatric conditions like:

  • Panic attacks
  • OCD symptoms
  • PTSD symptoms
  • Severe anxiety
  • Obtrusive thoughts
  • Depression

Long-Term Treatment for Benzodiazepine Withdrawal

The therapy for benzodiazepine withdrawal varies depending on why you are taking the drug and why you are discontinuing it. If you take benzodiazepines to treat mental disorders, your doctor will recommend an alternate treatment plan when you stop taking them. It might be a mix of psychotherapy and medication.

If you stop using benzodiazepines due to misuse, you may need further substance use treatment. This is especially true if you are also abstaining from other drugs such as alcohol or opioids.


Benzodiazepine withdrawal may not come easily, but it is a worthwhile step for people that wants to discontinue the drug after long use. The length of action of the medication and its duration of use determines the onset of the withdrawal effect. Withdrawal symptoms can range from mild to severe. It may last for a few days to like months before going away

No one should attempt discontinuation of benzodiazepine without a doctor’s supervision. The doctor may taper off the drug over a certain period to reduce the possibility of withdrawal effect.

If you experience life-threatening withdrawal symptoms, seek medical intervention.

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