The experimental treatment also included a BZD diary, a drinking diary, BZD withdrawal education, and assessments for ways of coping and “progressive relaxation exercise” 72. This was compared to a gradual https://ecosoberhouse.com/ taper without the other components of the treatment plan 72. There was no difference in the success rate of BZD discontinuation between the control and experimental groups in this case 72.

Quality Care

The use and discontinuation of alprazolam within 2 weeks disrupt sleep onset and quality, increasing suicide risks 51. Researchers investigating the correlation between anxiolytic and hypnotic drugs with mortality hazards examined over 100,000 patients in a retrospective cohort study. They found that the hazard of death was doubled in patients prescribed BZD compared to control patients 47. There was an association between the prescription of anxiolytic drugs and mortality, resulting in 4 excess deaths in the anxiolytic drug group within an average of 7.6 years 47. They found a 35% increased chance of developing a new non-melanoma cancer in users of hypnotics 48.

Clinical Guidelines

These drugs are crucial for the cessation of seizure activity, as they account for 1% to 2% of United States emergency department visits annually. Benzodiazepines may be administered for various indications, including, but not limited to, insomnia, acute status epilepticus, induction of amnesia, agitation, and anxiety, spastic, and seizure disorders. Emotional dependence can occur with long-term use of benzodiazepines for anxiety or panic disorders. People may become reliant on their benzodiazepine, and may be reluctant to stop because of their understandable fear that anxiety or panic attacks may return. The risk of physical or psychological dependence is another reason why medication should not be the only tool for managing anxiety and benzodiazepine withdrawal syndrome panic disorders. Working through underlying issues through talk therapy or cognitive behavioral therapy with a licensed psychologist, as well as having a supportive network is essential for managing anxiety and panic disorders.

• In some cases, withdrawal from benzodiazepines can be dangerous and even life-threatening.11 A medical professional can assess whether detox from benzodiazepines is a necessary part of your individualized treatment plan.
• They will need someone to drive them home and are usually drowsy until the next day, so will need to take a full day off of work.
• The unborn fetus is at high risk for “floppy infant syndrome,” characterized by muscle laxity, failure to suckle, and oversedation.
• Other important indications for the use of BZDs include the treatment of catatonia, seizure disorders, and alcohol and BZD withdrawal.
• There is significant concern regarding overprescribing of benzodiazepines and the resultant harms.

4. Special Populations and Withdrawal

In neonates, less than 1% of patients treated with benzodiazepines experience laryngospasm and bronchospasm. They may also experience ventricular arrhythmias, including ventricular bigeminy or premature ventricular contractions, vasovagal syncope, bradycardia, or tachycardia. Gastrointestinal reactions may include retching, nausea and vomiting, and excess salivation. CNS and neuromuscular adverse effects Alcohol Use Disorder may include euphoria, hallucination, ataxia, dizziness, seizure-like activity, and paresthesia. Benzodiazepines work by increasing the effect of a naturally-occurring brain chemical called GABA (gamma-aminobutyric acid). GABA blocks certain brain signals, which slows down the activity of the brain and nervous system.

• In a prospective longitudinal study on the effects of psychotropic drugs in the cognition of the elderly, Allard et al. 19 found no significant long-term effect of BZD use on cognition.
• The assessment should also include a validated measure of withdrawal symptom severity, ideally with the same instrument as the initial assessment.
• Clonazepam has been used in the outpatient setting as a medication for taping the use of BZD.
• Taking precautions is one of the best ways to protect yourself from unknowingly taking these drugs.
• Chronic use of BZD leads to a small but significant change in fluid intelligence, while long-term use of BZD correlates with worse cognitive decline when compared to the effects of using a high dosage 21.

Conditions

A person who uses them for 3–4 weeks and then stops suddenly is likely to experience withdrawal symptoms. People who use them in the long term may need to withdraw their use over a 3–12 month period that their doctor should oversee. Use of these drugs in older adults comes with risks of dependence, cognitive deficits (or impaired thinking), falls, and car accidents. The American Geriatrics Society (AGS) lists benzodiazepines as a class of medications that should be avoided in people 65 and older. This receptor is a protein called gamma-aminobutyric acid type A (GABA-A) receptor.

Substance abuse disorder treatment centers reported admissions for benzodiazepine abuse as the sole primary substance or drug of choice to have increased by 109% between 2003 and 2013. BZDs represent one of the most widely prescribed drug classes in the United States. They are used for immediate symptom relief of anxiety, epilepsy and other seizure disorders, spasticity from CNS pathology, catatonia, sleep disorders such as insomnia, and withdrawal from alcohol and other BZDs 3. Antidepressants (SSRIs/SNRIs) are considered first-line therapy for most patients with anxiety, but benzodiazepines may play an adjunctive role in the treatment of GAD to address acute symptoms while the antidepressant takes effect.

• However, this study included a small sample size, so a larger study using this standardized counseling method would increase the validity of the results of this study 73.
• An interaction occurs when one substance causes another substance to have a different effect than expected.
• This was further supported by data from Rooney et al. which reported that 54% of abusers of oxycodone are also dependent on a BZD 45.

This is not all the information you need to know about benzodiazepines for safe and effective use and does not take the place of your doctor’s directions. Discuss any medical questions you have with your doctor or other health care provider. View the pregnancy section of each individual drug monograph to determine pregnancy risk or benefit.

Psychological symptoms include increased excitability, nightmares, anxiety, insomnia, panic attacks, depression, hallucinations, irritability, paranoid thoughts, social phobia, poor memory, poor concentration, delirium, and even psychosis. These symptoms may last for one to a few weeks after cessation, with duration and severity largely depending upon the amount of time spent chronically taking the BZD, the half-life of the specific BZD, and the daily dose consumed 26. Benzodiazepines, or “benzos,” are a commonly prescribed class of medications known for their calming and relaxing effects. An estimated one in eight adults in the United States took benzodiazepines in 2018, which is 12.6% of the population.1 Benzodiazepines are most commonly prescribed to treat anxiety and panic disorders. Other uses for benzodiazepines include treatment of seizures, muscle spasms, pre-surgical sedation, and relief of alcohol withdrawal (“detox”) symptoms.