Best practices in benzodiazepine prescribing and management .. : The Nurse Practitioner

The primary difference between these drugs is the length of time they stay active in the body. However, benzodiazepines can cause physical dependence and withdrawal https://ecosoberhouse.com/ even when they are taken as directed. Benzodiazepines are a group of central nervous system depressants used to treat anxiety, insomnia, and seizures.

Best practices in benzodiazepine prescribing and management in primary care : The Nurse Practitioner

• View the pregnancy section of each individual drug monograph to determine pregnancy risk or benefit.
• Panic attacks may accompany other mood disorders such as depression, anxiety or substance abuse conditions.
• Elderly patients often require lower benzodiazepine doses due to slower metabolism of the drugs.

Still, due to the severe potential for dependence and deadly withdrawal sequelae, guidelines for recommended use are no longer than a few weeks. Despite this, numerous studies report usage extending for months into years or even decades in many users [9]. Additionally, according to several studies, BZD use increases with age, with long-term usage most prevalent in the 65 and older population [16]. Long-term use is defined as two or more months at a therapeutic dose and when used long-term, BZDs pose potential harmful effects. This is especially concerning in the elderly, who are at increased risk for psychomotor impairment, car accidents, and cognitive impairment such as anterograde amnesia-diminished short-term recall, and increased forgetfulness [11].

Table 1: Common Benzodiazepines Available in the U.S.

Addiction professionals agree that the best practice for individuals seeking to stop using benzodiazepines is to be weaned off these drugs during a medically supervised detox process. According to the American Psychiatric Association (APA), withdrawal symptoms from short-acting benzodiazepines peak on the second day and improve by the fourth or fifth. Withdrawal symptoms can occur after as little as one month of use, even on small, therapeutic doses. Among people taking benzodiazepines for longer than six months, about 40% experience moderate to severe withdrawal symptoms when they quit suddenly.

Can you prevent withdrawal?

Further studies need to be performed on not just gabapentin, but other medications for MMT patients with BZD dependence should be evaluated since treating them is more complicated. During the early years of my career, I studied mainly higher-potency benzodiazepines in a variety of conditions, but principally in panic disorder, and I helped lead pivotal studies for U.S. I perceived that popular opinion and research funding agencies trivialized anxiety distress, even as we have come to appreciate the critical role of anxiety and insomnia in risk for suicidal behavior (3). My work turned to focus on the antecedents of anxiety and the potential for early recognition and interventions to limit lifelong disability (4).

• Oxazepam, temazepam, and chlordiazepoxide which are low potency benzodiazepines are well tolerated with low toxicity levels.
• Supportive social networks and stable housing are positive prognostic indicators.
• New GABA-ergic drugs are being developed for mood disorders, and it is not yet clear how they compare with benzodiazepines, which also reduce many symptoms that occur with mood disorders.
• Anti-anxiety drugs like diazepam bind to TSPO on the surface of microglial cell organelles.
• Unless the patient is elderly, it is helpful to switch to a long-acting benzodiazepine in both withdrawal and maintenance therapy.

Abrupt discontinuation of benzodiazepines may lead to severe withdrawal symptoms. Stopping benzodiazepines all at once can be dangerous, so your doctor will likely guide you through a tapering regimen that involves gradually reducing your dose over time. If you experience severe withdrawal symptoms during tapering, tell your doctor so they can adjust your care plan as needed.

Enhancing Healthcare Team Outcomes

There may be other circumstances where you shouldn’t take benzodiazepines with certain foods or beverages. Your healthcare provider can answer questions about whether to change what you eat or drink while taking these medications. Benzodiazepines benzodiazepine withdrawal are a class of medications that slow down activity in your brain and nervous system. They’re most often used for treating anxiety and related mental health conditions, as well as brain-related conditions like seizures.

What can I not eat or drink if I’m taking benzodiazepines?

• Lorazepam, oxazepam and temazepam are less likely to have this risk due to fewer liver enzyme interactions.
• Every person’s body chemistry is different, and the time it takes for someone to develop a tolerance for benzos will vary from person to person.
• The experimental group in this study had a weekly 1/10-dose reduction after a 2 week stabilization period [72].
• Some of the variations in results may be attributed to cognitive criteria in which each study followed.

What are Benzodiazepines? Names & Uses

Long-Term Treatment for Benzodiazepine Withdrawal