What Are Benzodiazepine Withdrawal Symptoms?

Benzodiazepines, often referred to as benzos, is an anxiolytic made for treating anxiety, insomnia, and seizures. They are a commonly prescribed class of medications with brand names such as Klonopin, Valium, and Xanax.
 
While they help treat various conditions, benzodiazepines are potentially addictive, and some patients will develop a tolerance to them over time.  There are benzodiazepine withdrawal symptoms that occur if one were to suddenly stop taking the medication after being on them for an extensive period of time. Doctors do not recommend quitting such medications "cold turkey", as this can cause serious withdrawal symptoms, which varies in severity.
 
Usually, the withdrawal symptoms begin within 24 hours of quitting the medication, and it can last days to weeks.
 
Benzodiazepine Withdrawal Symptoms
As mentioned, benzodiazepines are part of a group of medications known as nervous system anxiolytics treating anxiety and sleep disorders. The common types include alprazolam, clonazepam, diazepam, and lorazepam.
 
They are potentially habit-forming easily which can result in physical dependence. If you are looking to quit taking a benzodiazepine medication, it should be under the guidance of your healthcare professional.  Your psychiatrist will help you wean off slowly and with proper coping strategies, among other tools for a comfortable withdrawal process.
 
There isn’t an exact guide to the symptoms, timeline, and the severity of withdrawal, as individuals have different experiences, depending on factors like:

• Duration of taking the medication
• The dosage
• If the prescription were misused
• The mental health condition
• If there are other drugs taken simultaneously
• Misusing alcohol or other drugs 

 
Common symptoms include:

• Physical aches or pains that can be uncomfortable or severe
• Abnormal sensations, like feeling there are bugs crawling on one’s skin
• Hyperventilation
• Muscle spasm
• Sweating
• Anorexia or weight loss
• Anxiety or panic attacks
• Hypersensitivity
• Depression
• Difficulty in concentration
• Nausea and/or vomiting
• Insomnia
• Hallucinations, delusions, or the detachment from reality
• Grand mal seizures
• Cravings for benzos or other drugs for sedation, which may lead to relapse

 
While there isn’t a definitive guide for everyone, there are 3 possible phases for withdrawals, having only an estimated timeline. Again, those taking benzodiazepines need to do so under the guidance of their healthcare professional and should never stop them right away, especially when they do not consult a professional or develop a plan.
 
Here are the following withdrawal symptom phases:
 
Early or Immediate Withdrawal
The early withdrawal, also called rebound symptoms, shortly occur after one stops taking benzodiazepines. The symptoms depend on the drug's half-life. For instance, the symptoms of short-acting medications like Xanax would come quicker compared to long-acting medications like Valium.
 
During this stage, one may experience symptoms of the condition the medication was treating starting to come back, even worsening without benzodiazepines.
 
Acute Withdrawal
Acute withdrawal will happen after experiencing immediate withdrawal symptoms, usually within a few days. The symptoms can last multiple days, sometimes much longer.
 
Most symptoms will occur during this interval.  Generally people report this period being the most difficult.
 
Protracted Withdrawal
While most symptoms would subside after acute withdrawal, there may be lingering side effects.
 
The British Journal of Clinical Pharmacology found that about 10-25% of those who use benzodiazepines for extended periods would experience withdrawal symptoms that can last for over a year. The protracted withdrawal symptoms are also known as post-acute withdrawal symptoms, including the following:

• Anxiety
• Depression
• Insomnia
• Loss of sex drive
• Mood swings
• Poor concentration

 
All of these symptoms may effect one’s quality of life, appearing without any warning and causing distress. Therapy and counseling, or even other medications, can help manage such symptoms.
 
There are coping strategies and medications used for the withdrawal from benzodiazepines, under the guidance of your addiction physician to come up with a treatment plan. That way the symptoms are monitored and their severity will be managed and minimized.
 
If you or a loved one plans to quit their prescribed dosage of benzodiazepines, do speak with your healthcare provider to find out if this is the right choice and how to go about it.