Table of ContentsView AllTable of ContentsOverviewSigns and SymptomsCopingWarningsLong-Term TreatmentResources
Table of ContentsView All
View All
Table of Contents
Overview
Signs and Symptoms
Coping
Warnings
Long-Term Treatment
Resources
What is the most important information I should know about benzodiazepine withdrawal?Benzodiazepines have a risk for dependence, addiction, and potentially dangerous withdrawal symptoms.Do not stop taking benzodiazepines without talking to your doctor first; your medication should be tapered slowly to reduce complications.
What is the most important information I should know about benzodiazepine withdrawal?
Benzodiazepines have a risk for dependence, addiction, and potentially dangerous withdrawal symptoms.Do not stop taking benzodiazepines without talking to your doctor first; your medication should be tapered slowly to reduce complications.
Benzodiazepines are a group of central nervous system depressants used to treat anxiety, insomnia, and seizures. Benzodiazepines are among the most commonly prescribed medications in the United States.Several types of benzodiazepines are sold under popular brand names likeValium(diazepam), Xanax (alprazolam), and Klonopin (clonazepam).
The primary difference between these drugs is the length of time they stay active in the body. However, benzodiazepines cancause physical dependenceand withdrawal even when they are taken as directed.
Verywell / Gary Ferster
Benzodiazepines Uses, Indications, and Side Effects
Overview of Benzodiazepine Withdrawal
Benzodiazepines can be habit-forming. Anyone taking them on a daily basis can develop a tolerance and dependence.
When you are physically dependent on a drug, it means your body can’t operate normally without it. If you stop or reduce your dose suddenly, you will experience withdrawal symptoms.
Withdrawing from benzodiazepines can be a difficult, even dangerous process. You can expect to feel anxious and on edge for several weeks. You might feel irritable and hypersensitive to everything around you. Insomnia is also common. During the first week, you can also expect physical symptoms like headaches and hand tremors.
Benzodiazepine withdrawal can be managed with a gradual dose reduction, which will cause milder symptoms that come and go in waves.
If you have been using benzodiazepines for longer than six months, suddenly stopping your dose can cause grand mal seizures and delirium—this is why it’s best to involve your doctor or healthcare professional in your withdrawal process.
Signs and Symptoms of Benzodiazepine Withdrawal
Withdrawal symptoms can occur after as little as one month of use, even on small, therapeutic doses. Among people taking benzodiazepines for longer than six months, about 40% experience moderate to severe withdrawal symptoms when they quit suddenly. The other 60% experience mild symptoms.
The severity of withdrawal symptoms is associated with a variety of factors, including:
When do benzodiazepine withdrawal symptoms start?The onset of benzodiazepine withdrawal depends on the specific medication you are taking. Short-acting drugs likeXanax (alprazolam)andAtivan (lorazepam)leave the system quicker, which means withdrawal symptoms can appear in as little as eight to 12 hours.Longer-acting benzodiazepines likeKlonopin (clonazepam)can stay in the system longer, which means it can be one to two days or even longer before withdrawal symptoms start.
When do benzodiazepine withdrawal symptoms start?
The onset of benzodiazepine withdrawal depends on the specific medication you are taking. Short-acting drugs likeXanax (alprazolam)andAtivan (lorazepam)leave the system quicker, which means withdrawal symptoms can appear in as little as eight to 12 hours.Longer-acting benzodiazepines likeKlonopin (clonazepam)can stay in the system longer, which means it can be one to two days or even longer before withdrawal symptoms start.
The onset of benzodiazepine withdrawal depends on the specific medication you are taking. Short-acting drugs likeXanax (alprazolam)andAtivan (lorazepam)leave the system quicker, which means withdrawal symptoms can appear in as little as eight to 12 hours.
Longer-acting benzodiazepines likeKlonopin (clonazepam)can stay in the system longer, which means it can be one to two days or even longer before withdrawal symptoms start.
Possible symptoms include:
Estimates suggest that 10 to 25% of people who take benzodiazepines for extended periods experience what’s known as protracted withdrawal.
Protracted withdrawal is a long-term withdrawal syndrome that may come and go for several months.
Symptoms will be milder than acute withdrawal and they can disappear for weeks at a time. Protracted withdrawal rarely lasts longer than one year.
Coping With Benzodiazepine Withdrawal
Benzodiazepine withdrawal can be risky, so it is best to work with a doctor. Depending on which benzodiazepine you are currently taking, your doctor may want to switch you to a different one before your taper begins. Short-acting benzodiazepines complicate withdrawal with too many ups and downs. Diazepam, a long-acting benzodiazepine, is the most common choice for dose tapering.
There is no standard tapering schedule for you to follow. Your doctor will help make an individualized tapering schedule based on your current dose and particular circumstances. Some people taper quickly, finishing up within two to three weeks. Others taper slowly over the course of several months.
During your taper, you may still experience some of the symptoms of withdrawal. This can happen after each dose reduction.
Your doctor can pause or slow down the taper if your symptoms are intolerable. To cope with these breakthrough symptoms, it helps to have a backup plan for dealing with anxiety. Helpful strategies include:
While there is no FDA-approved medication to treat benzodiazepine withdrawal, your doctor may also prescribe other medications to help you manage withdrawal symptoms. The medication Romazicon (flumazenil) is sometimes used off-label for withdrawal symptoms.
What Is Mindfulness?
Benzodiazepine Withdrawal Warnings
Benzodiazepine withdrawal can be dangerous when not handled properly. There is a risk that people who quit benzodiazepines without a taper may experience a life-threatening grand mal seizure. If you go into withdrawal without tapering, you also risk experiencing delirium andhallucinationsthat cause you to lose touch with reality—a terrifying and dangerous experience.
Some drugs are safe to quit on your own, but benzodiazepines are not.
Depending on your situation, your doctor may think it best to prescribe very small amounts of medication at a time. This will prevent you from altering the taper, but it might mean frequent trips to the pharmacy.
Some people, such as those with a history of complicated withdrawal, seizures, or severe mental illness, may be better suited for an inpatient setting. This can involve living at a detox facility or hospital for several weeks, where you can receive constant medical monitoring and psychological support.
Quitting benzodiazepines means that underlying psychiatric symptoms can reemerge worse than ever before. These may include:Panic attacksOCD symptomsPTSDsymptomsSevere anxietyObtrusive thoughtsDepression
Quitting benzodiazepines means that underlying psychiatric symptoms can reemerge worse than ever before. These may include:
If you are pregnant or are thinking about becoming pregnant, talk to your OBGYN or psychiatrist about your plans. Benzodiazepine use in pregnancy carries some risks. However, going through any withdrawal during pregnancy also has its risks. Your doctor can help you weigh the potential risks and benefits of benzodiazepine use and your pregnancy.
Lexapro Withdrawal: Symptoms, Timeline, & Treatment
Long-Term Treatment for Benzodiazepine Withdrawal
If your reasons for quitting benzodiazepines are that you were misusing them or unable to control your use, then you may require furthersubstance use treatment. This is particularly true if you are also giving up other substances, like alcohol or opioids.
Psychotherapy can help you understand the root cause of your substance abuse problems. It can also help you learn to identify psychological triggers that may cause you to relapse so that you can avoid them in the future.
The best resource in your quest to quit benzodiazepines is your prescribing doctor. If you prefer someone else, any primary care physician or psychiatrist can help you taper your dose.
To find a psychiatrist or psychologist who specializes in substance abuse issues, you can use this searchable directory from theSubstance Abuse and Mental Health Services Administration (SAMHSA). You can also call SAMHSA’s national helpline at 1-800-662-HELP (4357) to find a provider in your area.For more mental health resources, see ourNational Helpline Database.
To find a psychiatrist or psychologist who specializes in substance abuse issues, you can use this searchable directory from theSubstance Abuse and Mental Health Services Administration (SAMHSA). You can also call SAMHSA’s national helpline at 1-800-662-HELP (4357) to find a provider in your area.
For more mental health resources, see ourNational Helpline Database.
Symptoms of Addiction
7 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fuentes AV, Pineda MD, Venkata KCN.Comprehension of top 200 prescribed drugs in the US as a resource for pharmacy teaching, training and practice.Pharmacy (Basel). 2018;6(2):43. doi:10.3390/pharmacy6020043Bachhuber MA, Hennessy S, Cunningham CO, Starrels JL.Increasing benzodiazepine prescriptions and overdose mortality in the United States, 1996-2013.Am J Public Health. 2016;106(4):686-8. doi:10.2105/AJPH.2016.303061Substance Abuse and Mental Health Services Administration.Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality,Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285-94. doi:10.1111/bcp.12023Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr. 2015;38(5):152-5. doi:10.18773/austprescr.2015.055American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285-294. doi:10.1111/bcp.12023
7 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fuentes AV, Pineda MD, Venkata KCN.Comprehension of top 200 prescribed drugs in the US as a resource for pharmacy teaching, training and practice.Pharmacy (Basel). 2018;6(2):43. doi:10.3390/pharmacy6020043Bachhuber MA, Hennessy S, Cunningham CO, Starrels JL.Increasing benzodiazepine prescriptions and overdose mortality in the United States, 1996-2013.Am J Public Health. 2016;106(4):686-8. doi:10.2105/AJPH.2016.303061Substance Abuse and Mental Health Services Administration.Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality,Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285-94. doi:10.1111/bcp.12023Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr. 2015;38(5):152-5. doi:10.18773/austprescr.2015.055American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285-294. doi:10.1111/bcp.12023
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Fuentes AV, Pineda MD, Venkata KCN.Comprehension of top 200 prescribed drugs in the US as a resource for pharmacy teaching, training and practice.Pharmacy (Basel). 2018;6(2):43. doi:10.3390/pharmacy6020043Bachhuber MA, Hennessy S, Cunningham CO, Starrels JL.Increasing benzodiazepine prescriptions and overdose mortality in the United States, 1996-2013.Am J Public Health. 2016;106(4):686-8. doi:10.2105/AJPH.2016.303061Substance Abuse and Mental Health Services Administration.Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality,Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285-94. doi:10.1111/bcp.12023Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr. 2015;38(5):152-5. doi:10.18773/austprescr.2015.055American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285-294. doi:10.1111/bcp.12023
Fuentes AV, Pineda MD, Venkata KCN.Comprehension of top 200 prescribed drugs in the US as a resource for pharmacy teaching, training and practice.Pharmacy (Basel). 2018;6(2):43. doi:10.3390/pharmacy6020043
Bachhuber MA, Hennessy S, Cunningham CO, Starrels JL.Increasing benzodiazepine prescriptions and overdose mortality in the United States, 1996-2013.Am J Public Health. 2016;106(4):686-8. doi:10.2105/AJPH.2016.303061
Substance Abuse and Mental Health Services Administration.Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality,
Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285-94. doi:10.1111/bcp.12023
Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr. 2015;38(5):152-5. doi:10.18773/austprescr.2015.055
American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.
Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285-294. doi:10.1111/bcp.12023
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