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Using benzodiazepines is a complicated process. On the one hand, they are prescribed for anxiety, insomnia, and panic attacks leading you to believe that you have gained a necessary personal tranquillity.
On the other hand, if taken for a long time, the body will quickly adapt and there will be withdrawal symptoms which can still convince you that you are hooked and cannot quit. If you ever reach that stage where quitting the medication is your wish, be aware that this can be done albeit through a process that requires a lot of patience, planning, and professionals' assistance.
This guide is here for you to take the step of quitting benzodiazepines the safe and gentle way out, while at the same time, treating yourself positively along the road. The first and foremost rule is that the whole thing has to be under a very close supervision of some medical professional, your GP or a specialist.
Benzodiazepines belong to the class of sedatives that act in the central nervous system, thus letting GABA (gamma-aminobutyric acid), the neurotransmitter, exert its full effect. To sum it up, they decrease brain activity, which is why they do not only calm anxiety down but also help you fall asleep.
However, the human body is very resilient. It takes only a few weeks of regular meds for the brain to get so used to them that it starts to rely on them for its normal functioning. The brain's getting dependent on the drug is not a sign of a user's weakness; rather, it is a normal physiological response known as physical dependence.
If you decide to quit the medication suddenly, your brain would be abruptly deprived of the calming influence it has grown accustomed to. This could then trigger a severe, even rapid, development of withdrawal symptoms. Worst-case scenario, suddenly stopping the use of benzodiazepines can be quite hazardous, resulting in seizures or extreme psychological distress.
Never attempt to stop taking benzodiazepines without the guidance of a medical professional! You may have heard this thousands of times, but this is the golden rule you mustn't ignore.
The doctor or GP is the one whose collaboration you cannot forgo throughout this process. They will assist you in creating a precise and personalized tapering schedule. Tapering on your own is extremely dangerous as it might lead you to make a wrong call about the pace of reduction and thus suffer from withdrawal symptoms that make you quit the whole process.
Your physician will study a number of important points when figuring out your plan:
It is a requirement that the plan is put into writing, that both of you approve it, and that it is regularly checked. If at any time the withdrawal symptoms become so severe that they are hard to cope with, the doctor can alter the schedule by slowing the taper down.
When we talk about tapering that is safe, we mean one thing above all: slow. There are a number of strategies that are often used by doctors as common practice:
This is indeed the most popular technique and is frequently suggested as a first choice, particularly in the United Kingdom. In the beginning most patients are given short-acting benzodiazepines due to their quick rise and fall in blood concentration, thus making withdrawal more erratic.
To reduce the volatility your doctor might first transfer you to a long-acting benzodiazepine like Diazepam (Valium). Diazepam will stay in your system much longer thus giving you a more constant and steady level of medication. After being stabilised with the equivalent dosage of Diazepam medication, the actual tapering starts. This planned gradual fall is much more manageable for both body and brain.
The micro-reduction is the fundamental process of the taper - it does not matter if you keep on the same medicine or change to a long-acting substitute.
It's not a weekly reduction: Usually the dose is reduced every one to four weeks, depending on your handling of the situation. A typical first reduction might be 10% of your initial dose.
It's highly individualised: Some people can manage 10% reduction every two weeks; others might require full a month to stabilise after reducing by just 5%. Pay attention to your body, if you find it very difficult to cope then keep the current dose longer until you feel ready to cut down again. The slower the reduction the safer it is.
The final stretch: The last sections of the taper can sometimes be the most difficult because the doses are really tiny. This is the stage when the reductions need to be the smallest and slowest. At this time your doctor may even suggest that you use a liquid form of the drug in order to allow for extremely precise and tiny dose reductions.
Tapering off is not simply a matter of cutting down the medication; it is a process of nurturing a vibrant and environmentally-friendly life. When medicine gets to reduce, then increasing the supports and the coping mechanisms for the patient is very important.
During the withdrawal period, anxiety and insomnia may come back or become more intense. This is the right moment to take a step towards talking therapies such as Cognitive Behavioural Therapy (CBT). The therapist will help you learn and utilize the strategies that will make you manage anxiety without drug assistance. They will also clarify and resolve any mental health issues, which may have been the reason for the first prescription.
The following small changes in lifestyle will greatly contribute to the patient's strength during the tapering down process:
No need for you to suffer in silence. Reach out to the nearest or the online support groups that are specifically for people going through benzodiazepine withdrawal. It is very reassuring and can also open up the channel for getting guidance and sharing your feelings to get the strength you want if you are connecting with others who understand you so well in this moment.
The gradual withdrawal from benzodiazepines is a marathon, not a sprint. The therapy may last for several months or even up to a year or more, depending on the individual's past. You might experience fluctuations in your symptoms, and that is absolutely normal.
Treat yourself with patience. There is no award for being the quickest; the sole objective is to ensure total cessation of the drug and at the same time the excellent state of one's health.