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Benzodiazepine withdrawal syndrome (BZD withdrawal) is the cluster of signs and symptoms that may emerge when a person who has been taking benzodiazepines as prescribed develops a physical dependence on them and then reduces the dose or stops taking them without a safe taper schedule.
Withdrawal symptoms can persist for quite some time after discontinuing benzodiazepines. Some common protracted withdrawal symptoms include anxiety, depression, insomnia, and physical symptoms such as gastrointestinal, neurologic, and musculoskeletal effects. The protracted withdrawal state may still occur despite slow titration of dosage.
Antipsychotics are not recommended for benzodiazepine withdrawal (or other CNS depressant withdrawal states) especially clozapine, olanzapine or low potency phenothiazines, e.g., chlorpromazine as they lower the seizure threshold and can worsen withdrawal effects; if used extreme caution is required.
The mechanism underlying rapid response to benzodiazepines and zolpidem in catatonia is unknown. [6] The observation that zolpidem, a selective hypnosedative with little to no muscle relaxing properties, elicits a challenge response similar to benzodiazepines has called into question the hypothesis that lorazepam may reverse catatonia through myorelaxation.
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Although anxiety can temporarily increase as a withdrawal symptom, there is evidence that a reduction or withdrawal from benzodiazepines can lead to a reduction of anxiety symptoms in the long run. [4] [5] Due to these increasing physical and mental symptoms from long-term use of benzodiazepines, slow withdrawal is recommended for long-term users.
Librium (chlordiazepoxide) – a benzodiazepine used to treat acute alcohol withdrawal; Lithobid, Eskalith – a mood stabilizer; Loxam (escitalopram) – an antidepressant of the SSRI class; Lunesta (eszopiclone) – a non-benzodiazepine hypnotic; Luvox (fluvoxamine) – an antidepressant of the SSRI class
Lorazepam, sold under the brand name Ativan among others, is a benzodiazepine medication. [14] It is used to treat anxiety (including anxiety disorders ), trouble sleeping , severe agitation , active seizures including status epilepticus , alcohol withdrawal , and chemotherapy-induced nausea and vomiting . [ 14 ]