Experiencing rebound symptoms means the symptoms you had before taking benzodiazepines come back even stronger than before. The preferred treatment for cannabis dependence is psycho-social care. Patients who have been using large amounts of cannabis may experience psychiatric disturbances such as psychosis; if necessary, refer patients for psychiatric care. There is some evidence that lithium carbonate may be an effective medication for cannabis withdrawal management. However, until further research has established the efficacy of the medication for this purpose, it is not recommended for use in closed settings. Stimulants are drugs such as methamphetamine, amphetamine and cocaine.
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The physician must also assist and guide the patient through this critical recovery period. During withdrawal (whether due to tolerance or tapering) and recovery, patients often experience an irregular, unpredictable cycling between relative lessening and exacerbation of symptoms. This cycling can occur in a very short time (minutes), and can range to a substantial time (months).
Protracted withdrawal syndrome
On the other hand, mandated tapers, without complete understanding and assent by the patient, often fail. The literature on benzodiazepine dependence and withdrawal is reviewed with an emphasis on social and psychological considerations. The problems of when to prescribe, identifying withdrawal symptoms, effective communication with the patient, the structure of withdrawal programmes, and the use of drugs, psychological approaches and other services are discussed.
The benzodiazepine withdrawal syndrome and its management.
- Abrupt cessation is not recommended for those who have been taking the drug for more than four weeks.
- There is a large body of literature on BZWS, ranging from peer-reviewed publications to personal anecdotes.
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- Experiencing rebound symptoms means the symptoms you had before taking benzodiazepines come back even stronger than before.
Experts agree that the incidence of protracted symptoms in those who have abruptly stopped a benzodiazepine is higher, and those who have undergone a slow taper at the patient’s individual pace is almost certainly very much lower. Not everyone who cuts down or stops taking benzodiazepines will experience withdrawal symptoms. Some people experience no withdrawal on discontinuation, even with cold-turkey cessation—although there is no way to know who these severe benzodiazepine withdrawal syndrome people will be ahead of time, so it is not recommended. Others might experience a few weeks or months of uncomfortable, but bearable, symptoms. Unfortunately, there is another group of individuals that may experience severe symptoms, often for months or years on end. For these people, the intensity of withdrawal can be overwhelming and in some cases lead to death – either as a direct result of the withdrawal syndrome itself or as a result of suicide.
- Loss of significant initial improvement can prompt increased dosing that may be ineffective as well.
- If this does not adequately calm the patient, it may be necessary to sedate him or her using diazepam.
- Short-acting drugs like Xanax (alprazolam) and Ativan (lorazepam) leave the system quicker, which means withdrawal symptoms can appear in as little as eight to 12 hours.
- Several types of benzodiazepines are sold under popular brand names like Valium (diazepam), Xanax (alprazolam), and Klonopin (clonazepam).
What is protracted benzodiazepine withdrawal?
During the acute withdrawal phase, doctors may monitor the person and recommend other drugs to control problematic symptoms. A person’s withdrawal symptoms often depend on the half-life of the drug. Withdrawal symptoms from short-acting drugs, such as Xanax, may come on faster than withdrawal symptoms from long-acting drugs, such as Valium.
Encouraging a Patient to Withdraw
- The length of time between each dose reduction should be based on the presence and severity of withdrawal symptoms.
- People taking benzodiazepines regularly long term (longer than 2 to 4 weeks) may have symptoms of withdrawal even when they have not reduced the dose.
- Physiological dependence on benzodiazepines can occur following prolonged treatment with therapeutic doses, but it is not clear what proportion of patients are likely to experience a withdrawal syndrome.
- Though benzodiazepine withdrawal is a medical emergency due to the onset of withdrawal seizures, benzodiazepine intoxication is relatively benign.
- Refer to the patient’s assessment to determine if he or she is dependent and requires WM.
Benzodiazepines
Post-acute withdrawal syndrome symptoms by substance
