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Weaning off BENZODIAZEPINES After Long-Term Use By Dr Sadaf Cheema GPST2
Benzodiazepines a group of medications which have been used since the 1960s to treat: • anxiety • epileptic seizures • mania, • alcohol withdrawal • sleeping problems
How do they work? They boost the effect of a substance in the brain called – GABA. GABA is a neuro-transmitter – a chemical which is used in the brain to control the passage of impulses from one cell to another. GABA has a generally calming effect in the human brain.
What are the main side effects? • Sleepiness • Unsteadiness • Memory problems.
Benzodiazepines withdrawals Continuous use of 6 weeks ----- get withdrawal symptoms • difficulty in sleeping, feeling tense, agitated • dizziness, metallic tastes, and disturbances of vision. • Sometimes with severe withdrawal they produce confusion, hallucinations and epileptic fits. • Some people experience unpleasant symptoms for several months afterwards. Withdrawals will usually start within 48 hours of stopping or reducing the dose of a benzodiazepine. They can be mild and pass off within a few days
Managing withdrawal • If Benzodiazepine are used continuously for more than 3 weeks or so ----should not be stopped suddenly. • Most people withdraw from them gradually by reducing the daily dose every 2-4 weeks, by an 1/8 or a 1/4. It is better to reduce too slowly rather than too quickly. • Lorazepam, are harder to come off than others. • Sometimes in difficult situation, switch over lorazepam to Diazepam which is easier to come off. • 1mg of Lorazepam is roughly equivalent to 5-10mg of Diazepam.
Blood tests • Benzodiazepines are very safe and no routine tests are needed before taking them.
Other Helps: • Self-help treatments for anxiety and insomnia (psychologists, books, internet) • Psychological therapies and/or antidepressants are needed in the longer term. • Sleeping well • Cognitive behaviour therapy