Benzo Withdrawal Symptoms: What Are They and How Long Do They Last?
Key takeaways:
Benzodiazepines are a group of medications that treat several health conditions, such as anxiety and panic disorder. They’re sometimes called benzos. They have several risks, including misuse, dependence, and withdrawal.
Benzo withdrawal symptoms include anxiety, tremors, and trouble sleeping. In more severe cases, seizures can occur.
Benzo withdrawal symptoms may start within a couple of days and last several weeks. But some people report feeling symptoms for a year or longer. Your exact benzo withdrawal timeline depends on which benzo you were taking, your dose, and how long you took it for.
Table of contents
Benzodiazepines (commonly known as benzos) can be used to treat a variety of medical conditions. These include anxiety and panic disorders. But in many cases, experts recommend limiting benzo use to a few weeks. This is partly because long-term benzo use has been associated with negative effects, like withdrawal, addiction, and problems with memory.
If you’re prescribed a benzodiazepine, it’s important to know what benzo withdrawal symptoms look like. It’s also important to know the benzo withdrawal timeline — when do symptoms start and how long can they last?
What are benzodiazepines?
Benzos are a group of medications that treat many different medical conditions. These include anxiety, panic disorder, and insomnia (trouble sleeping). They also treat alcohol withdrawal symptoms, some muscle conditions, and some types of seizures.
Benzos work by affecting the brain. They bind (attach) to receptors in the brain called gamma-aminobutyric acid (GABA) receptors. GABA is a naturally occurring chemical in the body. It causes physical and mental relaxation. Benzos increase its activity, which has a calming effect on the body.
Examples of benzo medications
Some benzos work quickly but don’t last long in the body. Others may take slightly longer to work but tend to stay in the body longer. Each benzo is FDA approved for different reasons. Examples include:
Alprazolam (Xanax)
Diazepam (Valium)
Lorazepam (Ativan)
Clonazepam (Klonopin)
Temazepam (Restoril)
Chlordiazepoxide (Librium)
Clobazam (Onfi)
Clorazepate (Tranxene)
What are benzodiazepine side effects? Benzodiazepine side effects include dizziness and drowsiness. More seriously, benzodiazepine use can lead to falls, misuse, and overdose.
What are the signs of a benzo overdose? Knowing benzo overdose symptoms can help you act quickly if you witness an overdose.
Why is it best to avoid combining benzos and opioids? This risky combination can increase your risk of side effects. In serious cases, it can cause slowed breathing and overdose.
What is benzodiazepine withdrawal?
If you’ve been taking benzos for more than a few weeks, benzo withdrawal is possible. That’s why it’s best to limit benzo use to a short amount of time if possible.
Withdrawal describes the uncomfortable symptoms that can occur if you stop benzos abruptly or lower your dose too quickly. It’s not usually life-threatening. But in some cases, benzo withdrawal can cause seizures and delirium that may lead to death.
Benzos can also cause physical dependence. This is when your body becomes reliant on a substance to function normally. It can occur when you take certain substances repeatedly over time. Along with benzos, other substances such as opioids and alcohol can cause dependence.
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Experiencing benzo withdrawal is a sign that your body is dependent on benzos. Physical dependence on benzos can occur even if you take them exactly as prescribed. This is just one of the many reasons that long-term benzo use isn’t recommended for most people.
Benzo misuse, a type of sedative use disorder, can also occur with long-term benzo use. When this happens, long-term cognitive issues and overdose are also more likely.
What are benzo withdrawal symptoms?
Benzo withdrawal symptoms can be both physical and psychological. Examples of physical symptoms include:
Nausea and vomiting
Diarrhea
Shakiness, or tremors
Muscle pain or stiffness
Headache
Abnormal heart beats
Sweating
Examples of psychological symptoms include:
Trouble sleeping
Irritability, restlessness
Anxiety
Panic attacks
Worsening memory and concentration
Some withdrawal symptoms are more serious than those listed above. These include seizures, hallucinations, or delusions. In older adults, there’s a greater risk of falls and heart problems, like heart attack. If any of these serious symptoms occurs, call 911 or seek immediate medical attention.
Benzo withdrawal can be uncomfortable and sometimes dangerous. So you shouldn’t stop benzos abruptly if you’ve been taking them for more than a few days. Regardless of how long you’ve been taking benzos, talk to your prescriber before stopping them. They can help you come up with a plan for how to lower your dose slowly.
Benzo withdrawal timeline
The benzo withdrawal timeline varies from person to person. It depends on how long you’ve been taking your benzo and at what dose. It also depends on which benzo you were taking. For example, you may experience withdrawal symptoms more quickly after stopping a shorter-acting benzo like Xanax or lorazepam. If you were taking a longer-acting benzo — clonazepam, clorazepate, diazepam — it may take a little longer for withdrawal symptoms to appear.
Below, we’ll cover the different stages of withdrawal.
First few days after stopping a benzo
After stopping a short-acting benzo like Xanax or alprazolam, benzo withdrawal symptoms may appear within 2 days. But it may take longer to experience withdrawal symptoms after stopping a longer-acting benzo, like clonazepam or diazepam (2 to 7 days).
Initial benzo withdrawal symptoms include general discomfort, such as nausea, restlessness, and sweating. You may also feel muscle aches, a fast heartbeat, and insomnia. You may have an increase in anxiety and panic attacks. Higher doses of benzos may lead to more intense withdrawal symptoms. High doses of shorter-acting benzos may be most likely to cause intense withdrawal.
More seriously, benzo withdrawal can cause seizures, hallucinations, and delirium. But these outcomes are rare.
Days to weeks after stopping a benzo
Benzo withdrawal symptoms may last 2 to 4 weeks. But if you were taking a longer-acting benzo, such as clonazepam or diazepam, withdrawal may last longer.
During this time, withdrawal symptoms may lessen in intensity.
Weeks to months after stopping a benzo (protracted withdrawal)
Some people report protracted withdrawal symptoms long after stopping benzos. This is also sometimes called post-acute withdrawal syndrome. Some people have reported experiencing these symptoms for years.
Protracted withdrawal symptoms haven’t been well-studied. But symptoms are often brain related. These include long-term anxiety, nervousness, and decreased focus. But some researchers think these symptoms aren’t withdrawal symptoms. Rather, they say, these symptoms are a result of changes to the brain that can occur from long-term benzo use.
After you stop benzos, it may be hard to tell if you’re experiencing protracted withdrawal symptoms or the return of symptoms caused by your original condition. For example, if you were using benzos to treat anxiety or panic disorder, you may experience the return of anxiety or panic attacks after stopping your benzo. Often, you’ll need an alternative treatment to replace your benzo. Talk to your prescriber about how to best treat your condition.
What should you do if you’re having benzo withdrawal symptoms?
How to treat benzo withdrawal depends on why you’re experiencing it. Regardless, always contact your prescriber if you’re experiencing withdrawal. Their advice will depend on your individual situation. In some cases, they may recommend the following:
If you’ve missed a dose of your benzo, your prescriber may recommend taking your missed dose and then returning to your usual dosage schedule.
If you’ve stopped taking your benzo on your own, your prescriber will ask what symptoms you’re experiencing. If they’re mild, you may be able to manage them at home with medications. If they’re severe, you may need medical care in a clinic or hospital. And if you experience serious symptoms, like seizures or delirium, seek emergency care right away.
If you’re working on a benzodiazepine taper with a healthcare professional, they may recommend medications to manage your symptoms.
Benzo withdrawal treatment
One way to manage benzo withdrawal is to slow down your benzo taper. A slow taper can help minimize your risk of withdrawal. So talk to your prescriber about whether this is an option for you. In some cases, they may recommend tapering quickly.
Additionally, if you were taking a short-acting benzo like Xanax or lorazepam, your prescriber may recommend switching to a long-acting benzo like clonazepam or diazepam. This may help minimize withdrawal symptoms as you reduce your benzo dose over time.
Additionally, medications may be used to treat symptoms of benzo withdrawal. Examples include:
Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin) and acetaminophen (Tylenol), for muscle aches and headaches
Nausea medications, such as metoclopramide (Reglan) and ondansetron (Zofran), for nausea and vomiting
Antidiarrheal medications, such as loperamide (Imodium A-D) and bismuth salicylate (Pepto-Bismol), for diarrhea
Seizure medications, such as carbamazepine (Tegretol) and gabapentin (Neurontin), for sleep problems and mood changes like anxiety (off-label use)
Alpha agonists, such as oral clonidine, for anxiety and fast heart rate (off-label use)
Besides medications, behavioral therapy may also help teach you skills for managing benzo withdrawal symptoms. Additionally, therapy can help you address the underlying issues that benzos were treating, such as anxiety or panic disorder.
How can you stop benzodiazepines safely?
If you’re interested in stopping your benzo, talk to your prescriber before making any changes. If you’ve been taking benzos for more than a few weeks, work with your healthcare team to slowly decrease your dose.
Your prescriber can help you develop a plan for this. It may take several weeks or months. In some cases, it may take years to safely stop your benzo.
What are some resources for sedative use disorder?
Benzo withdrawal may be a sign of sedative use disorder. If you think you have a sedative use disorder, contact your prescriber right away. They can help you figure out if you should see an addiction specialist.
Additionally, there are other resources you can access on your own. These include:
Call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 to learn about resources in your area. This can help you find addiction treatment centers, support groups, and other resources.
Use SAMHSA’s online Behavioral Health Treatment Services Locator to find treatment facilities.
Consider joining a self-help group, such as Narcotics Anonymous, Pills Anonymous, or SMART Recovery.
If you’re looking for ways to support someone struggling with benzo misuse, check out our guide on the dos and don’ts of helping a person in this situation.
The bottom line
Benzodiazepines (also called benzos) are medications that treat various conditions, including anxiety and panic disorder. If you take benzos for more than a few weeks, benzo withdrawal symptoms can occur if you stop taking them or reduce your dose too quickly. This is especially likely if you’re taking large amounts. Benzo withdrawal symptoms include nausea and vomiting, tremors, and trouble sleeping. Muscle aches, headache, and anxiety may also occur.
Benzo withdrawal isn’t usually life-threatening, but it’s possible to experience serious symptoms like delirium and seizures in some instances. If these serious symptoms occur, it’s a medical emergency that requires immediate care.
How quickly benzo withdrawal starts and ends depends on what benzo you were taking, the dose you used, and how long you took it for. Withdrawal symptoms can start within a couple of days and last several weeks. In some instances, people may experience lingering symptoms for a year or more.
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References
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