Short-acting benzodiazepines, like triazolam, pass quickly through the body, so you’ll likely experience withdrawal symptoms sooner — sometimes within a matter of hours. The term ‘protracted withdrawal’ does describe the time sequence of symptoms after stopping serotonin based antidepressants, but is a poor choice of language when discussing this with your doctor. Withdrawal is considered something that goes away within days or weeks of stopping a drug. If you are going to talk to your doctor about these sorts of problems, then it is best to describe the problem as symptoms that happened after stopping the drugs [emphasis added]. I realize that many physicians will declare these new symptoms the start of a new mental illness – usually bipolar – but calling it protracted withdrawal just confuses the doctor. Although I refer to protracted withdrawal as drug neurotoxicity [emphasis added], it is still a bad idea to give the doctor a diagnosis rather than to present symptoms.

Why can’t I find a clinician who will validate or diagnose protracted benzodiazepine withdrawal syndrome?

These protracted symptoms are due to a major functional change within the neuroreceptors and areas of the central nervous system that benzodiazepines affect. Withdrawal symptoms for long-term users usually resolve within 6–18 months of the last dose. There are anecdotal reports from the benzodiazepine withdrawal support charities in the UK of protracted withdrawal persisting for five, seven, and even ten years post-cessation.

• One known case of death was that of David Stojcevski, an inmate at the Macomb County Jail 17 days into a 30 day sentence for an unpaid traffic ticket.
• Other benzodiazepines commonly used for alcohol withdrawal include chlordiazepoxide (Librium), diazepam (Valium), and oxazepam.
• More lower symptom or symptom–free days  start to occur and symptoms reduce in severity and number for most people.
• 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.
• A patient’s score on the AWS should be used to select an appropriate management plan from below.
• Allow the patient to stabilise on this dose of diazepam for 4-7 days.

Cost of Ativan

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. A therapist or other mental health professional can offer support with navigating these effects and helping severe benzodiazepine withdrawal syndrome improve your overall quality of life during the withdrawal period. 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.

Subacute Stage (Weeks to Months)

The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988. Patients withdrawing from inhalants should be observed every three-four hours to assess for complications such as hallucinations, which may require medication. Symptoms begin within 24 hours of last use of stimulants and last for 3-5 days. By Corinne O’Keefe OsbornCorinne Osborn is an award-winning health and wellness journalist with a background in substance abuse, sexual health, and psychology.

The Drug Enforcement Agency (DEA) classify benzodiazepines as a Schedule IV controlled substance. According to the classification, these drugs have a low potential for abuse and low risk of dependence. Withdrawal symptoms may begin after as little as 3–6 weeks of use, even when a person uses the drugs as the doctor directed. People who have been through acute withdrawal often say that this phase is the most difficult. There are three possible phases for benzo withdrawals, each with an estimated timeline.

Short-acting benzodiazepines like Xanax might result in faster onset but quicker withdrawal, while long-acting benzos like Valium might lead to a more prolonged withdrawal process. Symptoms may vary greatly between individuals, including occasional bouts of anxiety, insomnia, mood swings, or cognitive issues. While less common, some individuals may experience prolonged and intermittent symptoms that persist for an extended period. Withdrawal symptoms may be mild in people who take the drugs for short periods.

2. STANDARD CARE FOR WITHDRAWAL MANAGEMENT

Dizziness is often reported as being the withdrawal symptom that lasts the longest. Protracted symptoms continue to fade over a period of many months or several years. Use of sedatives like barbiturates and benzodiazepines can also produce withdrawal responses that resemble alcohol withdrawal syndrome. Autonomic and psychomotor dysfunction often characterize the withdrawal symptoms. The symptoms tend to develop 2 to 10 days after discontinuation of the agent. Gamma Hydroxybutyrate (GHB) is now a common club drug abused at nightclubs and all-night parties.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Ativan, your doctor may recommend taking a different medication instead. Patients with DTs or other severe withdrawal symptoms may require admission to the intensive care unit due to the risk of mortality. Sedative-hypnotic withdrawal is treated with substituting drugs that have a long duration of action, benzodiazepine or phenobarbital for a few days, followed by a decreasing dose over 2 to 3 weeks. It usually resembles a flu-like illness characterized by yawning, sneezing, rhinorrhea, nausea, diarrhea, vomiting, and dilated pupils.

Management of stimulant withdrawal

This syndrome is clearly not a disease entity; it probably represents an amalgam of pharmacological and psychological factors directly and indirectly related to benzodiazepine use. These symptoms merge into a complex clinical picture that may be further complicated by (3) the reappearance of underlying anxiety or depression and (4) possibly also by ill-understood long-term neurological effects of benzodiazepines. Just like the intensity or severity of symptoms, the duration of withdrawal can vary as well. For some, the withdrawal can take weeks or months—and for some it will last for years or never fully resolve.

• Patients should be allowed to sleep or rest in bed if they wish, or to do moderate activities such as walking.
• There are anecdotal reports from the benzodiazepine withdrawal support charities in the UK of protracted withdrawal persisting for five, seven, and even ten years post-cessation.
• If you go into withdrawal without tapering, you also risk experiencing delirium and hallucinations that cause you to lose touch with reality—a terrifying and dangerous experience.
• His death was a direct result of involuntary benzodiazepine cessation.

Medical detox involves tapering off the benzo drug under the supervision of a doctor. The symptoms of benzo withdrawal can vary, depending on many factors. Cannabis withdrawal is managed by providing supportive care in a calm environment, and symptomatic medication as required (Table 3).