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Understanding Benzodiazepine Tapering and Withdrawal Symptoms

This entry was posted in Signs & Symptoms and tagged , on by .
Medically Reviewed Fact Checked

Last Updated on June 29, 2023 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

If you have been experiencing certain mental health conditions, it is possible a physician has prescribed benzodiazepines. This drug is prescribed in an attempt to assist with everything from panic attacks and general anxiety to depression, sleep disorders, and even epilepsy. Benzos are commonly prescribed “off-label” for a wide range of unwanted conditions. 10

Unfortunately, long-term use of benzodiazepines can lead to potentially damaging short-term side effects and especially long-term consequences over extended use. Similarly alarming is the fact that benzodiazepine drugs are highly likely to cause dependency, which can lead to an unhealthy reliance on the drug to function normally. Some people eventually begin misusing benzodiazepine drugs.

Ceasing the use of benzodiazepines is typically preferable to the continued risk long-term use can create, but it can be a difficult process. In fact, if you’ve been taking benzos for even two weeks, it’s not recommended to cease use suddenly due to the unpleasant and potentially dangerous withdrawal symptoms that can occur.11 That’s why the team at Alternative to Meds Center advocates for a safe, medically supervised tapering process to help our clients become free from medications and other drugs. With the use of adjunctive therapies, we are able to help patients realign their addictive biochemistry and mitigate withdrawal symptoms.


We’ve helped thousands of families by offering the correct guidance and facilities to assist with helping individuals recover through medication withdrawal and overcome pharmaceutical dependence. Because of the dangers during withdrawal, tapering with Alternative to Meds Center works to make long-term recovery more effective and detoxing less symptomatically severe.

What Are The Long-Term Negative Effects Of Benzodiazepines Use?

Extended use of benzodiazepines has been connected to a number of maladies and illnesses that range from physical to psychological.

The most common long-term effects affect the mind, including increased likelihood of depression, constant fatigue and insomnia, and decreased ability to concentrate, as well as memory loss.

Patients who have formed a dependency on benzodiazepines, as well as those who have taken a benzodiazepine drug for an extended period, also report bodily issues, including chronic gastrointestinal issues like constipation and even irritable bowel syndrome (IBS) in more extreme cases. Others recovering from benzodiazepines experienced sexual dysfunction, increased prevalence of agoraphobia and anxiety, and even an increased risk of self-harm or suicide.

Some studies have also potentially linked overuse and extended use of benzodiazepines to a number of cancers, including lung, brain, breast, and other cancers. Other studies have potentially linked benzodiazepines to immune issues due to decreased endocrine system function.1

Do Benzodiazepines Need To Be Tapered Off?

To fully understand the dangers of long-term benzodiazepine use, the risks of abrupt discontinuation, and the importance of a safe tapering process, you should first understand the drugs’ intended purposes and how they function. The intake of benzodiazepines may help enhance the transmission of gamma amino-butyric acid (GABA), which is an inhibitory brain chemical that works to dampen neuronal signaling in the central nervous system. Omit the suggested deletion as the complex mechanics are not needed here. This activity induces calmness, sedation, and reduces anxiety in the patient.13

Unfortunately, with extended use, benzodiazepines can cause major alterations to the body and brain.

Tapering from Benzodiazepines
Because benzodiazepines bind to neurotransmitters like GABA, extended use can influence receptors to the point they are unable to regulate themselves properly without the assistance of the drug.2 Because of this, patients who cease using benzodiazepines can face major withdrawal symptoms once the body no longer has access to the regulatory chemical it has become dependent upon. At this point, tapering is the safest way to avoid further harm..

Why Tapering Benzodiazepines Is Important

By tapering your intake of benzodiazepines, you can minimize withdrawal symptoms and decrease the physical risks involved with benzodiazepine discontinuation. Reducing your benzo dependency by removing the drug slowly can help you cease use safely. Stopping the intake of a drug all at once leaves no time for your central nervous system to adjust to functioning without that substance and often leads to severe withdrawal symptoms and, in some cases, even death.

Still, even gradually tapering benzodiazepines is not risk-free and can cause withdrawal. If you are attempting to taper your use of benzodiazepines, medical supervision is a key way to attenuate the symptoms of withdrawal and treat any severe symptoms that arise. A medical professional who has the expertise and knowledge needed to make personalized titration calculations is an important factor in ensuring your system can handle each step of your reduced intake. Going “cold turkey” or proceeding without the medical understanding necessary to complete a proper taper can cause extreme withdrawal symptoms, relapse, or severe health concerns.

What Are The Most Common Withdrawal Symptoms When Tapering Off Benzodiazepines?

The severity of withdrawal symptoms when tapering an individual off benzodiazepines can vary depending on the length of use, dosage, impaired organ function, and other factors. There are a variety of withdrawal symptoms that can range from mild physical discomfort to severe bodily reactions. 3

Mental Fog and Headache

On the lower-intensity end of the withdrawal spectrum, patients can experience persistent headaches, fatigue, brain fog, and confusion. This mental exhaustion and headache can last anywhere from a few weeks to a few months as your body readjusts to life without benzodiazepines.

Sleep Disturbances

Similarly, poor or disrupted sleep patterns can be a frustrating, long-term effect of ceasing benzodiazepine use. Issues with sleep patterns can range from minor difficulties with sleeping to insomnia and random periods of wakefulness. Benzodiazepines can cause sleep issues to go in the other direction as well, with some patients reporting paradoxical sleep/wakefulness issues, excessive sleep or exhaustion as part of their withdrawal process.14

Mood Issues

Another commonly reported symptom of benzodiazepine withdrawal is unusual irritability, agitation, or other mood swings. Often, those tapering from benzos will show anger or lash out in frustration or anger. This is a key reason practices like meditation and mindfulness are recommended during benzodiazepine detox, to assist patients with overcoming cravings and developing better control over withdrawal agitation. [#15 below]

Nausea and Dizziness

A slightly more severe side effect of benzodiazepine withdrawal includes nausea, vomiting, dizziness, and balance issues. Many individuals experience nausea, but tapering too quickly could cause constant dizziness as well as vomiting throughout the process. The body often responds to minor withdrawals from a drug, similar to how it deals with hunger.

Seizures

One of the most intense potential withdrawal symptoms that can occur when ceasing benzodiazepine use is convulsions, also known as seizures. Withdrawal seizures are sudden electrical disturbances in the brain that will cause a patient to exhibit unpredictable and violent movements. This occurs because of a direct disruption of the body’s ability to provide signaling to the extremities without access to the drug. Seizures are much more likely to occur when benzodiazepines are discontinued abruptly and are more common in patients who have used the drugs at high doses for extended periods.18

Psychotic Episodes

Finally, in the most severe cases of withdrawal, a patient can undergo a psychotic episode in which the central nervous system will negatively react to not having a drug in the body. Symptoms can include intense panic episodes, hallucinations, confused thinking, delusions and severe seizures. Like withdrawal seizures, psychotic episodes are most common if a tapering plan is poorly managed or if a patient quickly transitions from a large, frequent dose of benzodiazepines to zero use. This drastic reduction can essentially disrupt the nervous system into psychosis.

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What Are The Best Ways To Prevent A Benzodiazepine Relapse?

talk therapy to prevent relapseOutside of severe withdrawal symptoms, one of the most critical concerns regarding benzodiazepine tapering is the patient’s risk of relapsing to eliminate cravings and withdrawal. Thus, one of the key tools to avoid relapse is by minimizing withdrawal through the proper tapering steps. Seeking professional assistance to create a custom-designed benzodiazepine taper is not only the safest method of ceasing benzodiazepine use but also the method least likely to cause relapse.

In addition, the use of professional individual and group therapy, meditation and mindfulness, physical activity, proper nutrition, and other essential tools can also act as a deterrent for a potential relapse. That’s why the tapering process is best done with professional help. With medical and professional support, you will have the tools you need to mitigate the frustrations and discomfort of withdrawal.

Does Your Brain Go Back To Normal After Benzodiazepines?

While extended use of benzodiazepines can have serious negative effects on your brain and body, it is possible for your brain chemistry to regulate after tapering off this medication.5 This process can take time, however, as GABA receptors must be repaired and restored by the body. If you experience a relapse, this can reset the clock for recovery.

With professional help and proper tapering techniques, you can start to see recovery from the long-term side effects of benzodiazepines anywhere from six months to a full year after you taper to zero. However, in some cases, this recovery time could take even longer. The most effective indicator of how long it will take to recover most of your normal cognitive and physiological function is the dosage, and how long you took benzodiazepines regularly.

Is It Possible To Overdose On Benzodiazepines?

Like most other pharmaceutical depressants classified as controlled substances, it is possible to overdose on Benzodiazepines. While overdoses can certainly occur with the excessive ingestion of benzodiazepines, more often, an overdose occurs when a patient takes it alongside other depressant drugs like opioids or alcohol. In other words, while some patients purposefully overdose and others over-ingest a single benzodiazepine substance, benzodiazepine overdoses often involve other drugs.7

There are several signs of a benzodiazepine overdose, including:
  • Difficulty breathing
  • Short respiration
  • Clammy skin
  • Dilated pupils
  • Rapid or weak heartbeat
  • Coma (in severe cases)

As expected, benzodiazepine overdose is most deadly when the drug is combined with another substance or drug that also causes respiratory depression. Unfortunately, according to the CDC, fatal overdoses of benzodiazepine drugs have become more common in recent years.4

If you or a loved one has overdosed on a benzodiazepine drug, it’s important to seek medical help immediately. There are medications such as Flumazenil which can temporarily counter the overdose and mitigate overdose symptoms until you can seek emergency medical assistance. Then, a professional can help you safely address the body’s dependence on benzodiazepines via a tapering program, substance use disorder rehabilitation, mental health services, and holistic therapies.9

Benzodiazepine FAQs

Patients currently using benzodiazepines to treat anxiety and other conditions may have several questions about the tapering process. Here are a few of the most common.

What Is the Most Important Step to Take When Tapering Off Benzodiazepines?

When tapering off benzodiazepines or any pharmaceutical medication, it’s important to seek medical and professional help to guide you on your journey toward independence from the substance. By working with medical experts and therapists, you can taper from the substance on a safely graduated schedule. This may allow you to avoid severe withdrawal symptoms and prevent relapse.

What Is the Most Common Withdrawal Symptom of Benzodiazepines?

Withdrawal symptoms can vary depending on the detox plan in place. If a patient attempts to quit benzodiazepines abruptly (cold turkey), or too fast, they may face seizures or psychosis. However, a patient on a safe tapering program will more commonly face less severe symptoms like nausea or chronic headache.

What Are Holistic Alternatives to Benzodiazepines?

Because benzodiazepines typically work to treat anxiety, it is important to address the whole-person effects anxiety can have on an individual. As a result, treatments like meditation, exercise 16, yoga 18, proper nutrition 17, as well as biofeedback and acupuncture, can help to attenuate the symptoms of withdrawal and address the effects of anxiety in a person.

How Long Does it Take to Fully Recover from Benzodiazepine Side Effects?

With proper management, patients recovering from the long-term side effects of benzodiazepines can take anywhere from six months to a year to experience restoration of cognitive function. It’s important to note that even after an individual has tapered off benzodiazepines, a relapse can cause a setback. Individuals who experience heavy use of benzos over a long period may take longer to restore function.

A Holistic Approach To Tapering Off Benzodiazepines

benzo holistic tapering sedona drug rehabWhether you are looking to overcome benzodiazepine use disorder or a way to safely cease taking your prescribed benzodiazepine medication, it is crucial to seek medical assistance and research options in holistic treatment. Alternative to Meds Center can help you achieve.
long-term recovery from benzodiazepine use with the medical tapering and holistic therapies you need to address all the effects this drug has had on your physical, mental, and emotional health. Through education, scientifically-backed treatments, and proven therapies to counter cravings and withdrawal symptoms, we can help you discover healthier alternatives to pharmaceutical medications. Learn more about how we can help you today by contacting Alternative to Meds Center.

1 (800) 301-3753 for Benzo Tapering at ATMC
References:

1. Edinoff, A. N., Nix, C. A., Hollier, J., Sagrera, C. E., Delacroix, B. M., Abubakar, T., Cornett, E. M., Kaye, A. M., & Kaye, A. D. (2021). Benzodiazepines: Uses, Dangers, and Clinical Considerations. Neurology international, 13(4), 594–607. https://doi.org/10.3390/neurolint13040059

2. Mechanisms Underlying Tolerance after Long-Term Benzodiazepine Use: A Future for Subtype-Selective GABAA Receptor Modulators? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321276/

3. 4 Physical Detoxification Services for Withdrawal From Specific Substances. (n.d.). NCBI. https://www.ncbi.nlm.nih.gov/books/NBK64116/

4. Nicholson, M.W., Sweeney, A., Pekle, E. et al. Diazepam-induced loss of inhibitory synapses mediated by PLCδ/ Ca2+/calcineurin signaling downstream of GABAA receptors. Mol Psychiatry 23, 1851–1867 (2018). https://doi.org/10.1038/s41380-018-0100-y

5. Challenges of the pharmacological management of benzodiazepine withdrawal, dependence, and discontinuation. (2018, February 9). NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896864/

6. Basińska-Szafrańska, A. Delayed crises following benzodiazepine withdrawal: deficient adaptive mechanisms or simple pharmacokinetics? Detoxification assisted by serum-benzodiazepine elimination tracking. Eur J Clin Pharmacol 78, 101–110 (2022). https://doi.org/10.1007/s00228-021-03205-x

7. Benzodiazepine Toxicity – StatPearls. (2022, June 27). NCBI. https://www.ncbi.nlm.nih.gov/books/NBK482238/

8. Liu S, O’Donnell J, Gladden RM, McGlone L, Chowdhury F. Trends in Nonfatal and Fatal Overdoses Involving Benzodiazepines — 38 States and the District of Columbia, 2019–2020. MMWR Morb Mortal Wkly Rep 2021;70:1136–1141. DOI: http://dx.doi.org/10.15585/mmwr.mm7034a2

9. Delanty N, Vaughan CJ, French JA. Medical causes of seizures. Lancet. 1998 Aug 1;352(9125):383-90. doi: 10.1016/S0140-6736(98)02158-8. PMID: 9717943.

10. FDA drug label Romanicon (flumazenil) injection (approval revised Feb 2009)

11. Guina J, Merrill B. Benzodiazepines I: Upping the Care on Downers: The Evidence of Risks, Benefits and Alternatives. J Clin Med. 2018 Jan 30;7(2):17. doi: 10.3390/jcm7020017. PMID: 29385731; PMCID: PMC5852433.

12. Ashton H. Guidelines for the rational use of benzodiazepines. When and what to use. Drugs. 1994 Jul;48(1):25-40. doi: 10.2165/00003495-199448010-00004. PMID: 7525193.

13. Jembrek MJ, Vlainic J. GABA Receptors: Pharmacological Potential and Pitfalls. Curr Pharm Des. 2015;21(34):4943-59. doi: 10.2174/1381612821666150914121624. PMID: 26365137.

14. McGill University Info Letter The Brain from Top to Bottom, How Drugs Affect Neurotransmitters (published online N.D.)

15. Van Gastel A. Drug-Induced Insomnia and Excessive Sleepiness. Sleep Med Clin. 2022 Sep;17(3):471-484. doi: 10.1016/j.jsmc.2022.06.011. Epub 2022 Sep 8. PMID: 36150808.

16. Marchand WR. Mindfulness meditation practices as adjunctive treatments for psychiatric disorders. Psychiatr Clin North Am. 2013 Mar;36(1):141-52. doi: 10.1016/j.psc.2013.01.002. PMID: 23538083.

17. Deslandes A, Moraes H, Ferreira C, Veiga H, Silveira H, Mouta R, Pompeu FA, Coutinho ES, Laks J. Exercise and mental health: many reasons to move. Neuropsychobiology. 2009;59(4):191-8. doi: 10.1159/000223730. Epub 2009 Jun 10. PMID: 19521110.

18. Low Dog T. The role of nutrition in mental health. Altern Ther Health Med. 2010 Mar-Apr;16(2):42-6. PMID: 20232617.

19. Ross A, Thomas S. The health benefits of yoga and exercise: a review of comparison studies. J Altern Complement Med. 2010 Jan;16(1):3-12. doi: 10.1089/acm.2009.0044. PMID: 20105062.

Originally Published Feb 4, 2019 by Diane Ridaeus


This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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