Benzodiazepines

Benzodiazepines, or “benzos,” are a class of pharmaceutical drugs prescribed for a

spectrum of mental disorders and ailments. They are used to treat moderate to severe
anxiety, panic attacks, epileptic seizures and even withdrawal symptoms from other
central nervous system depressants like alcohol. Because of their high potential to
cause addiction, benzodiazepines are generally prescribed for short-term use.
Benzodiazepines bind with special neurons called ​GABA receptors in a process that
slows overactive brain function and relieves severe mental stress.

Comparison of Benzos

Benzo Commercial name Common Dose

Diazepam Valium 5 mg

Clonazepam Rivotril / Clonac 0.25 mg ​(8 - 15 mg)

Bromazepam Lexotanil 6 mg

Alprazolam Alpram / Xanax 0.25 mg ​(2.5 mg)

Substance Dependence

People who take benzodiazepines for an extended amount of time may build up a
tolerance for some effects of the drugs. When tolerance occurs, your body requires a
larger dose or an increased frequency of use to achieve the same or similar effect that
the substance had on you when you began taking it.

If you continually use benzos, especially in larger quantities, you may develop a
physical dependency on the medication. When this happens, your body doesn't function
properly without it.

Of note, It is possible for someone to become physically dependent on the drug

even when used as prescribed.

You can experience ​withdrawal symptoms if you suddenly stop using benzos or
suddenly decrease your dose significantly. ​These symptoms could be life-threatening​.
Some users may continue taking it to avoid the onset of these unpleasant, ​potentially
life-threatening withdrawal symptoms​. The dangers of withdrawal from benzodiazepines
means that a person should not stop taking them without consulting with a medical
provider. If they are possibly dependent on the medication, they should be tapered off
gradually.
Side Effects of Benzos

● Drowsiness
● Fatigue​ / mild faintness
● Dizziness
● Difficulty concentrating
● Dry mouth
● Changes in sex drive
● Increased salivation
● Balance
● Slurred speech
● Appetite changes
● Memory problems
● Decreased coordination
● Irritability
● Confusion
● Urinary retention
● Tinnitus
● Changes in menstrual cycle
● Low blood pressure

Some of the serious side effects of benzos include:

● Slow and/or shallow breathing.

● Seizures
● Suicidality
● Increased heart rate / tachycardia
● Fainting
● Swelling
 ● Liver damage

The risk of side effects can be increased by ​mixing benzos with other drugs,
especially other depressants like alcohol or opioids. This can increase the risk of
potentially fatal breathing issues, sedation, or coma. Because of this, using alcohol or
illegal drugs while taking any benzodiazepine is never recommended, and any other
medications should be cleared by a medical provider.

Benzodiazepine Withdrawal
When the use of benzodiazepines ceases or the familiar dose is significantly cut down,
withdrawal symptoms typically emerge and can turn deadly. Benzodiazepine withdrawal
is especially dangerous because of the high-risk of seizures, coma, and even death.
Respiratory failure is also possible, especially when benzodiazepines are combined with
alcohol, opioids, or other Central Nervous System (CNS) Depressants.

Symptoms of Withdrawal
The withdrawal symptoms of benzodiazepines are physically and emotionally painful,
and can even be life-threatening if the user stops “cold turkey.” ​Those with a history of
taking higher doses or taking the substance for a prolonged time have the worst
withdrawal symptoms​. ​Benzodiazepine withdrawal symptoms are highly variable
and often come and go with no warning or control over it​. They may vary in severity
and frequency throughout all phases of the withdrawal process.

The most common benzo withdrawal symptoms, often called “rebound” symptoms
usually manifest within one to four days of discontinuing use, depending on the benzo
used, the amount of use, and the frequency of use.
These symptoms typically include:

● Sleep disturbances
● Insomnia
● Increased tension
● Nervousness / anxiety
● Panic attacks
● Difficulty concentrating
● Excessive sweating
● Heart palpitations
● Increased tinnitus
● Headaches / migraines
● Increased sensitivity to touch
● Body temperature changes
● Muscular stiffness or discomfort / muscle cramps
● Akathisia
● Mild to moderate changes in perception
● Cravings
● Hand tremors / shakes
● Hot and cold spells
● Extreme sensitivity to noise or light
● Blurred / burned vision
● Paresthesia or numbness / tingling in the extremities
● Digestive upset / strong appetite changes
● Diarrhea / nausea and vomiting
● Altered sensory perception (noises sound very loud, metallic taste, reduced
sense of smell)
● Depression
● Body tremors
Less common and more severe symptoms can occur as well. These include :

● Hallucinations
● Seizures / convulsions
● Hyperthermia
● Psychosis or psychotic reactions
● Increased risk of suicidal ideation

If you think you or someone else is going through withdrawal, seek medical help
immediately.

Rebound Anxiety and Insomnia

Benzodiazepines are mainly prescribed to treat mental health conditions including
generalized anxiety disorder and insomnia. Many people who stop taking these
medications experience increased anxiety or restlessness. This is called the rebound
effect.

Rebound effects from benzo withdrawal, such as anxiety or insomnia, typically last 2 to
3 days.

The difference between rebound effects and withdrawal is that rebound effects are the
return of previous symptoms that were in existence before benzodiazepine use began,
while withdrawal symptoms are caused by the body struggling to adapt to the end of
benzodiazepine use.
Tapering Down Therapy
At least 50% of patients experience some withdrawal symptoms when they stop taking
a benzodiazepine, and almost all patients experience strong withdrawal symptoms if
they stop the medication suddenly. Most experts now taper quite slowly, often taking
months and even years to completely discontinue the benzodiazepine.

A higher dosage of a benzo, as well as longer use, can increase the intensity and
frequency of the withdrawal symptoms. Short acting drugs (Xanax, Rivotril) are more
likely to produce withdrawal reactions than benzos with longer half lives (Valium,
Lexotanil) if they are discontinued rapidly, although the difference is usually small if they
are tapered in an appropriately slow manner. Panic patients seem to be more
susceptible to withdrawal symptoms than those with other anxiety disorders.

A slow tapering of the medication is best. One approach is to remain at each new lower
dose for two months before the next reduction. Tapering a benzo over a two-to
four-month period can lead to significantly less withdrawal symptoms.

Younger age is significantly associated with a favourable outcome, but outcome is not
related to duration or dosage of benzodiazepines, type of benzodiazepine, rate of
withdrawal, symptom severity, psychiatric history, marital status or sex.

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Read the first 3 stories.

https://www.benzo.org.uk/success.htm