Benzodiazepine Withdrawal Symptoms

Effective Benzodiazepine Withdrawal Treatment

Castle Craig provides specialised care for benzodiazepine withdrawal, offering compassionate support and proven treatment strategies for recovery.

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Page Clinically Reviewed on 18 July 20242 January 2025 by Kerry Canning, MBChB | Medical Editor

Benzodiazepines are sedatives which are used to treat severe cases of anxiety and/or insomnia. They are indicated for short-term (2–4 weeks) relief only and should be reserved for serious cases where symptoms are disabling or leading to significant distress.¹  

Benzodiazepines vary in their onset of action and duration of effect but can assist in relieving symptoms within 30–90 minutes. A commonly prescribed example of a benzodiazepine is diazepam. Prolonged use of benzodiazepines  is not recommended due to their addictive potential when used for longer than 4 weeks.²

Withdrawing from benzodiazepines can be a difficult process and is often accompanied by a variety of physical and psychological symptoms. These may include pain, tremors, nausea, anxiety, depression and confusion. Cognitive issues such as memory problems and difficulty concentrating can also occur during withdrawal.³

Whilst managing these symptoms can be challenging, there are effective strategies and professional support available to help you.

If you or someone you know requires detox for benzodiazepine withdrawal, we encourage you to reach out to us today. Our help centre staff will answer any questions you have about detox at Castle Craig. Our on-site specialist detox unit is designed to make this process as manageable and effective as possible.

Key Takeaways

Symptoms of Benzodiazepine Withdrawal 

If you are attempting to stop benzodiazepines, understanding the withdrawal symptoms is an essential first step towards successful recovery. These withdrawal symptoms can vary in severity and duration, depending on the duration of use and the type of benzodiazepine you have been using.

It’s important to be aware that this process is different for everyone. Whilst some may experience mild withdrawal symptoms, others may have more severe symptoms. These can include psychological symptoms such as anxiety, restlessness, irritability and even depression.³ Recognising these symptoms is an important step towards recovery.

Managing the symptoms of withdrawal is not just about getting through the physical discomfort, but also involves coping with the psychological effects.

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Physical Symptoms of Benzodiazepine Withdrawal

The physical symptoms of benzodiazepine withdrawal can vary in intensity and duration and can depend on various factors. These factors include type, dose and duration of benzodiazepine use, rate of withdrawal, use of other medications and characteristics specific to the user, including underlying health conditions and personality traits. Depending on these factors, individuals can experience different types and severity of withdrawal symptoms. For example, an individual taking a short-acting benzodiazepine can experience withdrawal symptoms within several hours, however, for long-acting preparations, symptoms can arise up to three weeks after the drug is stopped.  

The physical symptoms of benzodiazepine withdrawal can include^3,4:

• Head and/or neck pain 
• Headaches
• Dizziness 
• Blurred or double vision 
• Tremors or muscle twitches
• Seizures 
• Nausea and/or vomiting
• Abdominal cramps 
• Changes in appetite and/or weight 
• Physical symptoms of anxiety such as chest tightness, heart palpitations, sweating and shaking
• Sleep disturbances such as insomnia and nightmares.

These physical symptoms can occur during the initial or acute withdrawal phase, which typically lasts for a few weeks. However, some people may experience protracted withdrawal symptoms that persist for months or even years after stopping benzodiazepine use. This is known as “Benzodiazepine Protracted Withdrawal Syndrome (PWS) or Post-Acute Withdrawal Syndrome (PAWS)”. Protracted symptoms can include a burning sensation in the limbs, ongoing pain, persistent muscle jerks, and gastrointestinal problems.^3,5

Psychological Symptoms of Benzodiazepine Withdrawal 

Beyond the physical discomfort, individuals can experience a range of psychological symptoms when withdrawing from benzodiazepines. These symptoms, part of benzodiazepine withdrawal syndrome, can be challenging but understanding them can help you navigate this difficult process. 

Psychological symptoms of benzodiazepine withdrawal can include^3,4:

1. Anxiety: You may feel an overwhelming sense of dread or worry, often without a clear cause. This heightened anxiety can lead to panic attacks, where you feel an intense fear that often comes with physical symptoms like a racing heart, feeling faint, nausea and trembling⁶
2. Changes in mood: Some individuals can experience states of low mood, such as mild to moderate depression when withdrawing from benzodiazepines. Others can feel restless, irritable or aggressive
3. Confusion or psychosis: In severe cases, individuals can lose touch with reality, perceiving things that no one else can or holding strong false beliefs
4. Altered thought patterns: Obsessional or paranoid thoughts can arise during withdrawal, which can be incredibly distressing for individuals 
5. Cognitive changes: Memory loss and poor concentration can occur, possibly due to functional or structural changes within the brain⁵ 

If you recognise these symptoms in yourself or someone you know, please reach out and seek professional help. You’re not alone, and there are resources available to support you through the journey to recovery.

Risk Factors for Experiencing Severe Benzodiazepine Withdrawal Symptoms 

It’s important to consider the risk factors that can intensify the withdrawal process. The following are some risk factors which may affect the severity and duration of benzodiazepine withdrawal symptoms:

• Long-term use: Prolonged use of benzodiazepines  increases the risk of severe and/or extended withdrawal symptoms 
• Benzodiazepine misuse: Using a benzodiazepine without a prescription or not following prescribed instructions, can lead to more serious symptoms of withdrawal. This also applies to suddenly stopping the medication, which is not recommended
• Co-occurring mental health conditions: If an individual has an underlying condition like anxiety or depression, they may experience more severe or prolonged withdrawal symptoms 
• Polydrug misuse: Substance misuse involving multiple drugs can complicate the withdrawal process and increase its severity

It is important to remember that withdrawal should never be attempted without medical supervision. It’s fundamental to seek professional help to ensure greater safety and a more comfortable detox process.⁷

Benzodiazepine Withdrawal Timeline

Understanding these withdrawal symptoms is an important first step but knowing what to expect in terms of a timeline for benzodiazepine withdrawal can also be an incredibly helpful aspect of the recovery journey.

Unfortunately, it is difficult to determine an exact course or timeline of events in benzodiazepine withdrawal. Every individual’s journey will differ in terms of the symptoms they experience and the duration of these withdrawal effects. However, three possible phases of withdrawal have been identified, which can help to distinguish between early and later processes. 

The benzodiazepine withdrawal timeline can be divided into three phases:

• Immediate or early withdrawal:
  • Symptoms appearing shortly after benzodiazepine use is stopped are sometimes called rebound symptoms.
  • These symptoms can resemble the condition that the benzodiazepine was initially prescribed to treat, e.g., anxiety or insomnia.
  • Rebound symptoms can occur more commonly with short-acting drugs such as Xanax (alprazolam) as they remain in the body for a shorter amount of time.
  • Drug tapering, where the dose of the drug is reduced gradually over time, may help alleviate rebound symptoms.
• Acute withdrawal:
  • Most withdrawal symptoms occur during this phase.
  • This phase typically lasts between 5–28 days.
  • Symptoms can begin a few days after stopping benzodiazepine use and can last for several months.
  • This phase can necessitate medical intervention to manage problematic symptoms.
• Protracted withdrawal:
  • Lingering withdrawal symptoms, also known as post-acute withdrawal syndrome (PAWS)⁵, can occur in some cases.
  • Research has shown that up to 25% of individuals using benzodiazepines over extended periods experience protracted withdrawal, with symptoms lasting for 12 months or more.
  • Treatment options for this phase of withdrawal can feature therapy and/or medical management.

It’s important to note that withdrawal can be uncomfortable and sometimes dangerous. If you’re considering stopping benzodiazepines, it’s essential to do so under the supervision of a healthcare professional who can guide you through the process safely.⁷

Can You Detox from Benzodiazepines at Home?

You might be wondering if it’s possible to detox from benzodiazepines at home. It’s important to know that attempting this without professional medical supervision can be highly risky. Benzodiazepine dependence is a serious condition and the symptoms of withdrawal can be severe and potentially life-threatening.

While home detox can seem like a convenient and private option, it doesn’t provide the same level of safety as a medically supervised detoxification programme. At home, you won’t have access to immediate medical intervention if withdrawal symptoms become severe. This lack of immediate care can lead to dangerous situations.

A safer alternative is gradual dose reduction (i.e., drug tapering) under medical supervision. This process involves slowly lowering the dose of the drug over time, which can help to minimise withdrawal symptoms.⁷

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Benefits of Professional Benzodiazepine Detox 

Professional detox offers a medically supervised route for managing benzodiazepine withdrawal. This essential step in recovery provides the necessary support to discontinue benzodiazepine use safely. In a supervised setting, skilled medical professionals are available to monitor and manage evolving withdrawal symptoms and make timely adjustments to treatment. By slowly tapering off the medication, this approach facilitates the careful management of severe withdrawal symptoms.⁷ 

Benzodiazepine Addiction Treatment After Detox

Professional detox sets a strong foundation for recovery however, the journey does not end there. It is equally important to continue engaging in recovery strategies after benzodiazepine detox. Treatment in an inpatient addiction treatment programme ensures a comprehensive approach to your ongoing care, involving individual psychotherapy, group therapy, 12-step therapy, and lifestyle coaching.

A continuing benzodiazepine addiction treatment plan might include^7,8:

Getting Help for Benzodiazepine Addiction at Castle Craig

Seeking help for benzodiazepine addiction is a courageous step and Castle Craig is committed to making the admissions process as smooth and supportive as possible. The first step is to contact Castle Craig’s admissions team for a free and confidential phone call. During the initial consultation, you can discuss your concerns, ask questions and get a clear understanding of what treatment involves.

The admissions team will conduct an assessment to evaluate your medical history, addiction severity and any co-occurring mental health conditions. This assessment is reviewed by our Consultant Psychiatrist and helps to create a personalised treatment plan tailored to your specific needs. Our team ensures that the process is straightforward and that all necessary information is collected to facilitate a smooth transition into the treatment programme.

Medically Managed Detox

Detoxification is a critical first step in recovering from benzodiazepine addiction. Castle Craig offers a medically supervised detox programme designed to ensure safety and comfort. The detox process at our clinic is managed by a team of experienced medical professionals who provide 24-hour care. This support is necessary as benzodiazepine withdrawal can be challenging and sometimes dangerous if not properly managed.

Benzodiazepine Therapy Programme

As benzodiazepine detoxification can take many weeks, the therapy programme begins as soon as the patient is stable enough. This ensures that any underlying mental health conditions are treated simultaneously, alongside the addiction. Residential rehab delivers benzodiazepine detoxification and therapeutic care through a multidisciplinary team working together to meet your needs.

Continuing Care as an Outpatient

Continuing care with Castle Craig through our outpatient clinic ensures that you have ongoing support and resources tailored to your needs. The outpatient clinic provides access to experienced professionals who can guide you through each step of your recovery, helping to maintain your progress and prevent relapse.

Reach Out for Help

If you or a loved one is struggling with benzodiazepine addiction, reaching out for help is crucial. Our team is ready to provide the support and care needed to overcome addiction and build a healthier future. Please don’t hesitate to contact Castle Craig’s admissions team for advice on starting the process.