What are your thoughts on this research paper

 

The benzodiazepine withdrawal syndrome.

Review article

Pétursson H. Addiction. 1994.

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Abstract

Physiological dependence on benzodiazepines is accompanied by a withdrawal syndrome which is typically characterized by sleep disturbance, irritability, increased tension and anxiety, panic attacks, hand tremor, sweating, difficulty in concentration, dry wretching and nausea, some weight loss, palpitations, headache, muscular pain and stiffness and a host of perceptual changes. Instances are also reported within the high-dosage category of more serious developments such as seizures and psychotic reactions. Withdrawal from normal dosage benzodiazepine treatment can result in a number of symptomatic patterns. The most common is a short-lived "rebound" anxiety and insomnia, coming on within 1-4 days of discontinuation, depending on the half-life of the particular drug. The second pattern is the full-blown withdrawal syndrome, usually lasting 10-14 days; finally, a third pattern may represent the return of anxiety symptoms which then persist until some form of treatment is instituted. Physiological dependence on benzodiazepines can occur following prolonged treatment with therapeutic doses, but it is not clear what proportion of patients are likely to experience a withdrawal syndrome. It is also unknown to what extent the risk of physiological dependence is dependent upon a minimum duration of exposure or dosage of these drugs. Withdrawal phenomena appear to be more severe following withdrawal from high doses or short-acting benzodiazepines. Dependence on alcohol or other sedatives may increase the risk of benzodiazepine dependence, but it has proved difficult to demonstrate unequivocally differences in the relative abuse potential of individual benzodiazepines.

 

PMID 7841856 [indexed for MEDLINE]

 

 

 

 

https://www.ncbi.nlm.nih.gov/m/pubmed/7841856/

Basically withdrawal last 10-14 days. After that is just a rebound anxiety?

Hi Boogyman

 

Thanks for the article.

 

Am I wrong or this piece was particularly referring to the abrupt discontinuation of benzo also known as cold turkey? Can't seem to find the idea of taper anywhere.

Not sure. But I think any form of "significant" dosage adjustment produces this type of reaction.

1-4 days of withdrawal. 2 weeks of the real withdrawal. Then withdrawal is over. Back to the rebound anxiety. According to the article.

So basically it is not that bad hehehe. Just managing anxiety after the withdrawal is over.

The big question for me, do we confuse anxiety with withdrawal? Because anxiety can have billion physical symptoms. Is it a matter of anxiety management after the 2 weeks are over?

Meditation, relaxation, exercise, good diet.

I'm dry cutting. I was hitting 1.5mg Xanax daily 10 days ago after 5 months of daily Xanax use. I decided to go to 0.5mg Xanax daily. For the last 10 days I have been doing better. Headaches here and there and anxiety. But anxiety is a buddy of mine I know it very well and it knows me very well.

I will go to 0.25 in 2 weeks. Then stop. I will post my progress once I go to 0.25.

But this is consistent with I have experienced. Anxiety is the beast to manage after 2 weeks.

When I read the abstract. . .I immediately thought ( blah blah - blah blah blah )

 

If we cut the dose slowly to half our normal dose. Then even slower to 0 we will not suffer the worst of withdrawal symptoms. Maybe a feeling of being uncomfortable for a while.  I'm sure it has variations from person to person. The panging feeling of missing our drug could also be interpreted as giving our body a chance to heal itself. 

This is a very old article .. ample evidence that this is not correct.

This is a very old article .. ample evidence that this is not correct.

 

How does "old" equate to "not correct"?

 

This is a very old article .. ample evidence that this is not correct.

 

How does "old" equate to "not correct"?

 

 

I mean it was published a long time ago so there has been more research since then. 

 

The most common is a short-lived "rebound" anxiety and insomnia, coming on within 1-4 days of discontinuation, depending on the half-life of the particular drug. The second pattern is the full-blown withdrawal syndrome, usually lasting 10-14 days; finally, a third pattern may represent the return of anxiety symptoms which then persist until some form of treatment is instituted.

 

10-14 days seems rather short

 

and it is suggesting that if anxiety symptoms return you should take more drugs. 

IMO what it suggests is to manage anxiety. Managing anxiety with benzos is not a lot long-term solution. But we are here. It seems to me that a lot of people confuse anxiety with withdrawals.

Cutting slowly is an option. But there are other options if you understand that anxiety is a good Mimicer. Withdrawals are over in 2 weeks. Anxiety is what takes place after.

Instead of obsessing with withdrawal symptoms which is anxiety, and that adds more to anxiety. I would focus on managing anxiety not withdrawals.

If you never had panic disorder and agarophobia then withdrawals are debilitating. Because that gives you a taste of panic disorder and agarophobia. But if you have had them, then dizziness panic attacks headaches are controlled with exercise, and relaxation techniques and CBT. This is my opinion I speak for myself and my experience

Withdrawal can last considerably longer than 10-14 days, it can last for many months.

What is withdrawal?

I assume it is the time taken for the drug to leave the body which in my case was about six months after finishing my taper .. that was when I entered the acute stage.  I have been advised that can happen as the drug is stored in the body.  I had taken it for 40 years.  I don't know where in the body it is stored.  I am not sure when the post-withdrawal would have started in my case ... even not sure when to say protracted started but it is all academic really as it is a benzodiazepine-related brain injury rather than withdrawal and that is why some of us are sick for years rather than months.

I hope we all feel better. Sorry to hear that. Wishing you the best of recovery.

Thank you so much.  I hope you will be well soon..

They are just starting to figure out how substances affect the body.

I remember as I was a kid alcoholics were told to do a cold turkey and I always thought why dont they taper

now I have seen doctors working successfully exactly that way.

 

We are pioneers here, sadly..  some kind of lab rats