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Some of the symptoms that could possibly occur as a result of a withdrawal from benzodiazepines after long-term use include emotional clouding, [1] flu-like symptoms, [5] suicide, [11] nausea, headaches, dizziness, irritability, lethargy, sleep problems, memory impairment, personality changes, aggression, depression, social deterioration as ...
High doses of many shorter-acting benzodiazepines may also cause anterograde amnesia and dissociation. [4] These properties make benzodiazepines useful in treating anxiety , panic disorder , insomnia , agitation , seizures , muscle spasms , alcohol withdrawal and as a premedication for medical or dental procedures. [ 5 ]
One of the recommended benzodiazepine taper is to reduce the dose by 50% in the first 4 weeks, maintain the dose for 1–2 months, and then reduce the dose by 25% every 2 weeks. [15] Other common side effects of benzodiazepines are drowsiness, dizziness, somnolence and increased risk of ataxia.
Diazepam is seen as a good choice for tapering for those using high doses of other benzodiazepines since it has a long half-life thus withdrawal symptoms are tolerable. [88] The process is very slow (usually from 14 to 28 weeks) but is considered safe when done appropriately. [89]
The changes are most notable with long acting benzodiazepines as these are prone to significant accumulation in such individuals and can lead to withdrawal symptoms. [citation needed] For example, the equivalent dose of diazepam in an elderly individual on lorazepam may be half of what would be expected in a younger individual.
The higher the dose and the longer the drug is taken, the greater the risk of experiencing unpleasant withdrawal symptoms. Withdrawal symptoms can also occur from standard dosages and after short-term use. Abrupt withdrawal from therapeutic doses of temazepam after long-term use may result in a severe benzodiazepine withdrawal syndrome.
Chlordiazepoxide is generally considered an inappropriate benzodiazepine for the elderly due to its long elimination half-life and the risks of accumulation. [10] Benzodiazepines require special precaution if used in the elderly, pregnancy, children, alcohol- or drug-dependent individuals and individuals with comorbid psychiatric disorders. [11]
Flunitrazepam, sold under the brand name Rohypnol among others, [3] is a benzodiazepine used to treat severe insomnia and assist with anesthesia. [4] As with other hypnotics, flunitrazepam has been advised to be prescribed only for short-term use or by those with chronic insomnia on an occasional basis.