Benzodiazepine Withdrawal

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Chemical formula of a Benzodiazepine

Chemical formula of a Benzodiazepine

As we covered in our first article on benzodiazepines , benzodiazepine withdrawal and dependency are major problems. Due to the shortsightedness and ignorance of medical “professionals” who prescribe these drugs for long-term periods, benzodiazepine withdrawal becomes a painful and long journey. In this article, we will discuss some of the methods and treatment regimens benzo-dependent individuals can utilize to wean themselves off these addictive compounds.

Why are benzodiazepines addictive?

To begin, we need to rehash the reasons these drugs are so addictive and dependency-inducing. The physical mechanism by which benzos act has everything to do with their addictive potential. The actual biology and biochemistry behind this mechanism is rather complicated, so we will speak from a more general point of view. When you take a benzodiazepine, a sequence of events occurs both in the short-term and the long-term.

As you may know, dopamine is the “pleasure chemical.” It is predominantly found in the ventral tegmental area (VTA) of the brain; that is, the middle of it. To regulate the dopamine system, inhibitory interneurons cause the dopamine-producing neurons to “slow down.” Benzodiazepines take these inhibitory systems offline and allow more dopamine to be produced by activating GABAA receptors which control the inhibitory systems. These resulting spikes of dopamine are what cause the addiction and dependency, because the synaptic adaptions in a sense re-program the neurons to respond to higher levels of dopamine which cannot be naturally produced.

Why is it so difficult to stop using benzodiazepines?

As explained in the previous section, benzodiazepine dependency is a complex chemical and neurobiological process. The physical structure of the brain is altered. Thus, the addiction and dependency are not simply a psychological problem; rather, it is also a physiological problem. In other words, without proper treatment on both the psychological and physiological fronts, a full recovery is uncertain.

It is also crucial to point out that subsequent withdrawal periods to the initial one are more difficult to endure. Studies hypothesize that the permanent biological and biochemical changes induced by benzodiazepine use drastically alter the dopamine system and other important neurotransmitter systems.

What happens during a benzodiazepine withdrawal period?

In short, it is unpleasant. The exact symptomology will, of course, depend on the individual patient, but the following symptoms are possible in all withdrawal instances:

  • Sleep disturbance
  • Irritability
  • Increased tension and anxiety
  • Panic attacks
  • Palpitations
  • Headaches

It will not be an easy journey. But it is possible to completely end a benzodiazepine addiction.

What treatment options are available?

Firstly, we are not psychiatrists or medical professionals of any sort. We advise you to consult with a psychiatrist or an addiction and withdrawal professional. There is no one sure-fire way to overcome a benzodiazepine addiction. However, there are a few constants between individual cases.

Most benzodiazepine users will require a period of gradual withdrawal. In psychiatry, this period is called “tapering.” The key is to slowly and gradually wean off the drug in question. The tapering schedule we have listed at the end of this article recommends a reduction of about 25 percent of the initial dose every two weeks.

A relatively new drug has emerged to combat the symptoms of benzodiazepine withdrawal on a biological level: Flumazenil. Lower relapse rates, a reduced symptom profile, and reduced hostility and aggression are all scientifically studied features of Flumazenil. How does it work? As we previously discussed, benzodiazepines cause GABAA receptors to become downregulated. Flumazenil reverses these effects and encourages the growth of new GABAA receptors.

To summarize, the benzodiazepine withdrawal period will require at least a few months of tapering, counseling, and discipline. Innovative treatments like Flumazenil help to make this process far more bearable than it was in the past and allow the patient to avoid relapsing after rehabilitation. It is important to seek out treatment centers, doctors, and other professionals who have experience in properly treating benzodiazepine addictions.

However, if controlled rehabilitation and professional guidance are unavailable to you, there are many self-study resources on the Internet. We have listed two below:

Further Reading

Below, we have included a number of resources related to benzodiazepine withdrawal and recovery.

The benzodiazepine withdrawal syndrome.

Tapering Benzodiazepines

Well-Known Mechanism Underlies Benzodiazepines’ Addictive Properties

A pilot study of the effects of flumazenil on symptoms persisting after benzodiazepine withdrawal

Have you experienced or are experiencing a benzodiazepine withdrawal? We would like to hear about the challenges you face and how you overcome them in the comments section below.

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