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Benzodiazepine Withdrawal Symptoms, Timeline, and Effects

Bottle of benzodiazepine pillsBenzodiazepines are prescription medications that are often used to treat anxiety, panic disorder, seizures, muscle spasms, and in rarer cases, insomnia.1 Common benzodiazepines include Valium, Xanax, Klonopin, and Ativan.

After using benzodiazepines for an extended period of time, the brain adapts to the presence of the drug, and the person must take more and more to experience a high. This phenomenon is known as tolerance. Along with tolerance, the person may develop physiological dependence, and they will then need to continue using the benzodiazepine drug to feel good and function well.

If a person who is dependent abruptly stops taking the drug, he or she will experience benzodiazepine withdrawal signs as the brain struggles to cope without the drug.

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The withdrawal process for benzodiazepines is difficult and can be life-threatening. Some people experience symptoms such as seizures, hallucinations, heightened anxiety, and problems sleeping. The timeline can last anywhere from several days to several weeks. 3

If you or someone you care about is struggling with benzodiazepine addiction or withdrawal, medical detox is the safest and most comfortable path to recovery. Medical detox centers can prescribe medications to lessen the unpleasant side effects of withdrawal and monitor your health. To find a detox center, call 1-888-935-1318Who Answers? today.

Signs, Symptoms, and Effects

Symptoms include anxiety, sleep problems, nausea, sweating, and seizures.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a person who experiences 2 or more of the following symptoms within several hours to a few days after quitting or slowing their benzodiazepine use may be experiencing benzodiazepine withdrawal:

  • Anxiety
  • Difficulty falling asleep or staying asleep
  • Hallucinations, such as hearing, seeing, or feeling things that are not there
  • Nausea or vomiting
  • Psychomotor agitation (difficulty sitting still)
  • Racing heartbeat
  • Seizures
  • Sweating
  • Tremors, or shaking hands3

Withdrawal Factors

Many factors influence withdrawal effects. For example, the timeline and severity of the withdrawal process can be affected by:

  • Length of time a person used benzodiazepines.
  • The average dose they regularly took.
  • How frequently they took the drug.
  • Whether the person used benzodiazepines in combination with alcohol or any other drugs.
  • The person’s mental health and medical history.

Post-Acute or Protracted Withdrawal

Following detox and the more commonly experienced acute withdrawal period, some people may experience post-acute withdrawal symptoms (PAWS), also known as protracted withdrawal.5 Some protracted benzodiazepine withdrawal signs include:

Man having anxiety from benzodiazepine withdrawal

  • Persistent anxiety.
  • Chronic insomnia.
  • Unexplained aches and pains.
  • Difficulty performing complex tasks.
  • Poor concentration.
  • Loss of sexual energy.
  • Depression.5

Protracted withdrawal effects often mimic mental health conditions such as depression and anxiety, so they can be difficult to distinguish from a mood disorder.

Protracted withdrawal signs sometimes emerge after the person has completed addiction recovery treatment. Therefore, it is important to maintain a reliable support system and continue recovery—such as by seeing an individual therapist or attending support groups—after finishing detox and a drug rehab program. Even though not everyone experiences protracted withdrawal symptoms, those who do may require a higher level of support to avoid relapse.

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Withdrawal Timeline

Benzodiazepine withdrawal timelines differ from person to person and are affected by factors such as the length of time the drug was used and whether the person used any other drugs in combination with benzodiazepines. The timeline will also vary depending on which type of benzodiazepine the person used.

  • Short-acting benzodiazepines (Ativan, Xanax, Restoril): Withdrawal effects begin within 6-8 hours, peak around the second day, and begin to improve on the fourth or fifth day. 3
  • Long-acting benzodiazepines (Valium, Librium): Withdrawal effects may not develop for more than a week, peak during the second week, and improve during the fourth or fifth week. 3

Medical Complications

One of the most serious medical complications associated with benzodiazepine withdrawal is seizures. Other problems such as ataxia (loss of bodily control) and poor coordination can cause falls or other dangerous accidents.4

During the detox and withdrawal phases of recovery from benzodiazepine use, seek medical help if you experience any medical complications, including:

  • Seizure – a loss of consciousness followed by uncontrollable bodily movements such as jerking, twitching, or muscle tension
  • Loss of bodily control – such as poor coordination or involuntary muscle spasms
  • Depression – such as a loss of interest in activities, difficulty sleeping, and feelings of hopelessness
  • Suicidal thoughts or behaviors – including but not limited to talking about death, wishing one were dead, giving away possessions, or attempting to harm oneself 4,5

Relapse Risk

Relapse following benzodiazepine treatment is another serious concern. Many people who return to using benzodiazepines after stopping use for an extended period of time go back to using their previous dose. However, the person’s tolerance levels drop after being without the drug. Resuming use with a high dose can lead to overdose, especially when combined with other sedative medications or alcohol.4

Find a Detox Center

Finding a detox center that will provide you with the kind of support you need can be the best choice you make in your recovery. Contact our support helpline at 1-888-935-1318Who Answers? to find a detox center that can help you get started with the withdrawal process.

Read next: Benzodiazepine Withdrawal Medications and Help

Sources

[1]. Drug Enforcement Administration. (n.d.). Drug Fact Sheet: Benzodiazepines.

[2]. National Institute on Drug Abuse. (2012). Well-Known Mechanism Underlies Benzodiazepines' Addictive Properties.

[3]. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. (5th Edition). Arlington, VA: American Psychiatric Publishing.

[4]. Substance Abuse and Mental Health Services Administration. (2010). TIP 45: Detoxification and Substance Abuse Treatment.

[5]. Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal. Substance Abuse Treatment Advisory, 9 (1), 1-8.

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