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Benzodiazepine withdrawal symptoms

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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