Benzodiazepine withdrawal syndrome

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.

Typically, benzodiazepine withdrawal is characterized by sleep disturbance, irritability, increased tension and anxiety, depression, panic attacks, hand tremor, shaking, sweating, difficulty with concentration, confusion and cognitive difficulty, memory problems, dry retching and nausea, diarrhea, vomiting, loss of appetite and weight loss, burning sensations and pain in the upper spine, palpitations, headache, nightmares, tinnitus, muscular pain and stiffness, and a host of perceptual changes. More serious symptoms may also occur such as depersonalization, restless legs syndrome, seizure and suicidal ideation.

Withdrawal can be managed through awareness of the withdrawal reactions, individualized taper strategies according to withdrawal severity, the addition of alternative strategies such as reassurance, and referral to benzodiazepine withdrawal support groups.