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Benzodiazepine withdrawal symptoms

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Withdrawal symptoms may result from dosage reduction as well as from complete withdrawal (1). In around 20-30% of patients, withdrawal symptoms from benzodiazepine develop after 4-6 weeks of use (1)

The most important effect of benzodiazepine is the anti anxiety effect, hence most of the acute symptoms of withdrawal are those of anxiety state (2).

symptoms similar to anxiety state in general include:
- anxiety, panic attacks, agoraphobia
- insomnia, nightmares
- depression, dysphoria
- poor memory and concentration
- dizziness, light headedness
- tremor
- muscle pain, stiffness
- sweating, night sweats
- palpitations
- blurred or double vision
symptoms less common in anxiety state but relatively specific to benzodiazepine withdrawal are:
- perceptual distortions, sense of movement
- depersonalization, derealisation
- hallucinations (visual, auditory)
- distortion of body image
- tingling, numbness, altered sensation
- formication (skin ‘crawling’)
- sensory hypersensitivity (light sound, taste, smell)
- muscle twitches, jerks, fasciculation (3)

A minority of patients may suffer from long term effects (protracted symptoms) which might be present months or even years after withdrawing from benzodiazepines.

in patients who have undergone a slow taper under their own control is less likely to have protracted symptoms
some protracted withdrawal symptoms include:
- anxiety
- insomnia
- depression
- various sensory and motor symptoms - tinnitus, tingling, numbness, muscle pain, weakness, painful cramps
- poor memory and cognition
- gastrointestinal disturbance

Reference:

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