Benzodiazepine Withdrawal: Symptoms, Timeline, & Prevention

What Is Benzo Withdrawal?

Benzodiazepine withdrawal occurs when patients abruptly stop their dosages. When a person becomes used to the relaxing effects of benzos, their body will react negatively in the absence of these calming substances. Moreover, benzos can cause physical dependence in patients, resulting in symptoms of withdrawal.² However, it’s important to note that these adverse effects are not necessarily indicative of an addiction to the medication.

Withdrawal symptoms are more likely to occur in those who have taken benzos for an extended period of time. Nevertheless, this discomfort may be avoided with an effective exit plan. Your provider can recommend a tapering dose to decrease the chances of experiencing withdrawal.¹

Are Some Benzodiazepines More Likely to Cause Withdrawal?

The probability of withdrawal increases for those who have been prescribed benzos with a higher potency and less absorption time. Providers typically aim to slowly increase the strength of a person’s dosage or opt for one with an extended release component to limit negative reactions of withdrawal. This allows for more consistent and long-lasting effects, rather than short spikes of relief from anxiety.¹

Some of the most common medications that cause benzodiazepine withdrawal include:

• Xanax
• Halcion
• Serax

Benzo Withdrawal Symptoms

Benzos result in a relaxed physical state by utilizing GABA, an inhibitory channel in the brain. When medication is stopped, one’s body becomes hyperactive, due to the immediate decrease in GABA activity.⁴ Reactions to this can vary, so making sure to watch for warning signs of withdrawal is crucial. The most common symptoms are generally mild and include anxiety, insomnia, sweating, and other physical discomforts.^{1, 3} More severe reactions will require medical attention. As noted, symptoms can be lessened with proper guidance from a provider. Alternatively, you may ask your clinician about switching to a medication that has a longer half life.¹

Common benzo withdrawal symptoms that may occur after stopping benzodiazepines include:

• Anxiety
• Sweating
• Tremors
• Dizziness

Severe benzodiazepine withdrawal symptoms that require immediate medical attention include:

• Seizure
• Hallucinations
• Delirium

Benzo Withdrawal Timeline

Benzo withdrawal may occur almost immediately after the stopping of medication. The timeline of withdrawal is dependent on how long a prescription has been present in a patient’s body. For example, a longer acting benzo will stay in your system for longer, resulting in an extended withdrawal timeline. You should expect to see mild symptoms within the first few days of quitting your dose. These effects will gradually increase in intensity before tapering off. While every patient’s experience is different, withdrawal typically lasts about 14 days.³

The extent of one’s withdrawal depends on a multitude of factors. Regardless, symptoms are typically worse for patients who have been medicating with benzos for a long time. Similarly, higher potency and shorter half life prescriptions heighten the onset of withdrawal symptoms.² Finally, having a previous history of withdrawal can also increase a person’s likelihood of experiencing it again.

Early Withdrawal

Early withdrawal begins within the first 1-4 days of stopping benzos. These reactions are generally mild and include anxiety and insomnia.³ Seeking medical attention at this stage can help you prevent worsening symptoms from occurring.

Acute Withdrawal

The acute phase of withdrawal typically lasts between 10-14 days and occurs after the early withdrawal stage. Depending on the strength, duration, and half life of the benzos, this stage can begin sooner or later in the timeline. Patients may experience delusions, hallucinations, and seizures during this time.³

Protracted Withdrawal

After acute withdrawal, patients may return to their baseline levels of anxiety or notice an increase in their symptoms of anxiety.³ This can last for a month or longer until replacement treatment for your anxiety is pursued.

Discontinuation of Benzos After Long-Term Treatment

Symptoms may be worse and last longer for patients who have become physically dependent on benzos. Most doctors will initiate a tapering dose of medications to decrease the likelihood of withdrawal. In this way, you’ll also be better equipped to handle negative symptoms as they come.

Coping With Benzo Withdrawal Symptoms

Your clinician or provider may be able to offer different ways to cope with withdrawal. They may recommend that you restart your regimen and then stop effectively using a tapering dose. However, remember that you may notice a resurfacing of underlying anxiety symptoms following benzo cessation.

Strategies to help with benzo withdrawal relief include:

• Restart Your Dosage: Restarting benzo medication can help the body stabilize when going through withdrawal.
• Substitute Your Prescription: Benzo substitution is when higher potency, short acting benzos are replaced with lower potency, longer acting alternatives. This creates a baseline amount of medication within the body, which may lower the chance of withdrawal.

Getting Off Benzodiazepines Safely

While benzodiazepines medications can be addictive, formulating a safe tapering plan with your care team, psychologist, and doctor can help alleviate the chance of experiencing severe withdrawal. There is no standard for tapering doses, as every patient will have individualistic needs and medical regimens.

Questions to Ask Your Health Team About Getting Off Benzodiazepines

Before attempting to stop your benzo regiment, being sure that you have all the information you need to be successful is helpful. Speaking to your health care team is the best way to get a better understanding of how to taper off benzo doses.

Questions to ask your care team about stopping benzos include:

1. What is my tapering dose and what is the prescription schedule that I should be following?
2. What are signs of withdrawal that I should look for?
3. What should I do if I am experiencing withdrawal?
4. What are my other options for anxiety medications?
5. How can I get a different anxiety medication?
6. Who should I call if I need to talk about my symptoms?

Final Thoughts

With any medication, side effects vary based on the individual. It’s important to discuss your wishes to end benzodiazepine doses with your doctor and care team before altering them on your own.

For Further Reading

• Benzodiazepines – DEA
• Lorazepam (Ativan): Uses, Side Effects, Dosage, & More
• Ativan Vs Xanax: Differences, Similarities, & Which to Take
• Best Online Psychiatry Options