The authorsacknowledge the medical writing and editing services of Jo Ann LeQuang, whose feeswere covered by the Alliance for Benzodiazepine Best Practices. While most respondents who wrote in comments expressed difficulty and despair, afew had fully or partially positive experiences with benzodiazepine treatmentand/or discontinuation. It would be important to identify this group as well asthose for whom withdrawal is difficult; the latter need specialists to treatthem, but not the former. The aim of this study is to assess the experiences of those taking, tapering,or having discontinued benzodiazepines. Although there are no FDA-approved medications for the treatment of frontotemporal dementia, available data indicate that SSRIs, trazodone, and amphetamines may reduce behavioral symptoms in these individuals [21].
- A total of 1682 individuals started the survey, of whom 1207 respondents wereidentified by the source system as having finished the survey, although some ofthese ‘finishers’ did not answer every question.
- A “cut and hold” method involves reducing the current dose by a set amount (not more than 5% to 10% of the current dose) and holding the new dose until symptoms subside.
- It’s worth noting that the combination of the Ashton Method with these supportive therapies not only fosters a safer tapering environment but also emphasizes the holistic well-being of individuals undergoing benzodiazepine withdrawal.
They can range in severity, though for some people, they remain mild and manageable. Dependence and withdrawal can happen to anyone, even if you take your medication exactly as instructed. One disadvantage to this method is that most medications are not water-soluble (meaning they are not fully dissolved in water), so the resulting liquid suspension must be shaken to distribute the medication fully. John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH). Medical professionals do not want to hear a long story as they are very pressed for timeb.
Benzodiazepine Overdose
At its core, tapering is about slowly familiarizing the body to live without benzos while making withdrawal manageable. Pharmacotherapy interventions have limited use in benzodiazepine withdrawal. Generally, other drugs are used to address symptoms rather than substitute for benzodiazepines.
Medications Used When Tapering off Benzodiazepines
A few said that their physicians ‘abandoned’ them as theystruggled to discontinue benzodiazepines. Many respondents described withdrawal as the worst experience they ever had. For Lewy body dementia, the use of acetylcholinesterase inhibitors particularly rivastigmine and donepezil are recommended [20]. Drugs with substantial anticholinergic properties should be avoided given the risk for cognitive decline and delirium.
Support BIC
The authors identifiednine broad themes and selected relevant comments to represent each. Many respondents had taken more than one type of benzodiazepine, whether concurrentlyor sequentially. The most frequently taken benzodiazepines were clonazepam (52.9%),alprazolam (41.7%), lorazepam (36.1%), and diazepam (32.1%). Patients wereprescribed benzodiazepines for a wide range of conditions (see Table 1). There are no FDA-approved treatments for vascular dementia, but identifying and managing comorbidities and ensuring that vascular risk factors are optimally managed have been shown to improve the quality of life of these individuals [22].
Several major psychiatric and medical organizations have put out society guidelines advising against their use in older adults, because they increase the risk of hip fracture, worsen the risk of dementia, and increase confusion, to name a few. The most important thing in cessation of a benzodiazepine is patient safety. Still, how long after taking clonazepam can i drink alcohol the methods mentioned here can lead many patients to a tolerable taper and maximize the patient’s chance for successful cessation and complete healing. In the liquid titration approach, a pill is either crushed or allowed to disintegrate in a premeasured (in milliliters) amount of milk or water to create a suspension.
Some patients micro-taper using a scale by removing a small amount, perhaps between 0.001 and 0.003 grams, every day or every few days. This method can initially be intimidating to many, and a few different approaches exist. Videos and resources are available in online support groups explaining the various approaches. Some patients who find the rate of reduction used in the Ashton Manual to be intolerable but are not able, for whatever reason, to use a liquid approach choose this method. However, this method poses several serious health risks and is not encouraged. Many people can trace their hesitation to stop benzos to the withdrawal symptoms.
Common Benzodiazepine Withdrawal Symptoms
It was the intention of theauthors to collect the largest sample size possible. People tapering off the same original dosage of medication can have drastically different tapering experiences. 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. Experiencing rebound symptoms means the symptoms you had before taking benzodiazepines come back even stronger than before.
On the other end of the spectrum, quitting cold turkey provides no such safeguard — withdrawals are at their worst, even deadly. For this reason, neither at-home detoxes nor stopping cold turkey are recommended by physicians. The information below is intended as a reference only, and should not be taken as medical advice. If you have questions about your medications, consult your https://sober-house.org/ pharmacist, doctor, nurse, or other healthcare professional. While a few respondents were able to discontinue benzodiazepines with few or nosymptoms, whether abruptly or over time, many wrote in about persistent anddisturbing symptoms. Some respondents had completely discontinuedbenzodiazepines but still had symptoms, including one whose symptoms weremisdiagnosed as fibromyalgia.