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What Causes Heart Palpitations, Nausea And Dizziness Post Benzodiazepine Withdrawal?

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Posted on Mon, 13 Apr 2015
Question: Hi I am having acute benzodiazepine withdrawal I've been off the medicine for about two weeks after tapering down over a period of three weeks I completely off and now I'm having heart palpitations, hr over100, Major blood pressure fluctuations, severe stomach pain an nausea dizziness tremors, brain fog, confusion, unsteadiness, panic. I am taking gabapentin and Toprol to help with detox but not sure if it's working.
doctor
Answered by Dr. Dr. Matt Wachsman (47 minutes later)
Brief Answer:
withdrawal doesn't last that long

Detailed Answer:
IF it is 2 weeks after the last dose of benzodiazepines (probably even Quaaludes), the drug has been out of your system for nearly that whole time. The peak of the withdrawal is 1-5 days after, not 10.

ON the other hand.... anxiety disorder occurs when off of anxiety meds and often/usually is worse for weeks after stopping. Addiction, cravings, other disorders can also be occurring. Cannot say in your particular case. and anti-depressants with anti=anxiety effects would usually also be given.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (42 hours later)
I was told that the withdrawel could last many weeks or even months or years from Klonopin. I have been very sick with stomach pain and nausea and have had a lot of anxiety. I also have blurred vision,dizziness, disorientation brain fog, insomnia and tingling in head and extremities. Could this be more of a side effect from the gabapentin or metropol that I am taking? I am very sensitive to medications and often have a lot of side effects.
doctor
Answered by Dr. Dr. Matt Wachsman (11 minutes later)
Brief Answer:
it's a description of anxiety/panic attack

Detailed Answer:
" a lot of anxiety. I also have blurred vision,dizziness, disorientation brain fog, insomnia and tingling in head and extremities" is a description of a panic attack.

It's not very associated with either gabapentin nor metoprolol. Indeed, metoprolol has been considered as a treatment for panic attack (doesn't work). WithDRAWAL from metoprolol is very well known to do this....and symptoms last hours or about 1-2 days. Withdrawal from gabapentin is pretty rare to have any side effects.

In someone with a history of anxiety and panic attack, those symptoms are 100% associated with anxiety/panic. They might be from a drug, but has to be less likely than from panic. Beta blockers and anti-epileptics and klonapin all damp down activity. They are very UNLIKELY to trigger disorders/feelings of having too much activity. On the other hand, stopping them often triggers feelings of being out of contol.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (32 minutes later)
I do not normally have the blurred vision that only started after started taking the gabapentin and is listed as one of the side effects. I don't get the dizziness are the disorientation from my panics either . Also i get sweats and stomach pain, burning right after taking the metropol. When panic occurs I normally have shakes, heart palpitations fear and a feeling like I'm out of control. Not all the other symptoms I described. Would it be safe to go off gabapebtin and metropol in the next couple of weeks? I can't drive with the vision problems and dizziness. How long have you done addiction treatment and how much experience do you have with benzo withdrawel? Just curious
Also I am not withdrawing from gabapentin or metropol. Still on them
doctor
Answered by Dr. Dr. Matt Wachsman (11 hours later)
Brief Answer:
Gabapentin and metoprolol withdrawal

Detailed Answer:
are not nearly as safe as the drugs.

"sweats and stomach pain, burning right after taking the metropol"
the drug takes time to work--see figures... any of them.
http://www.ncbi.nlm.nih.gov/pubmed/0000
15 min onset at the earliest.. peak at 1 hr. It's the action on the stomach which is at least as likely just the physical irritation of a pill and less likely to be metoprolol which doesn't increase stomach acidity.
Blocking stress hormones can make one feel blah, or tired, or unable to do exercise as much.
The body gets used to the metoprolol blocking stress hormone receptors and stopping them suddenly can potentially make one stressed. Standard is to lower in 50% increments every week, check bp and heart rate. The withdrawal symptoms occur within really 24 hrs after a change.. nearly always within 24 hrs... but certainly within 72hrs. The change in bp and heart rate with stopping can be measured by the doctor even at levels that are not very noticeable.

On gabapentin and blurred vision. Look closer. Antiepileptic drugs damp down nerves. By definition. There are consequences from this and changes in the eye aren't one of them. There's a 30% sedation rate on it, even at low doses of gabapentin.
People feel they don't see right with that. The PDR doesn't say blurred vision per se, but amblyopia and nystagmus.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/
Also, the eye muscle focusing ability is messed up and the eye's wobble (nystagmus).
Also, there's likely a difficulty on focusing ability and the eyes don't lock onto an object as well, but they haven't done the perfect study to demonstrate it.
It's a brain effect not an eye effect. Feels like an eye effect.
Tiredness, very common with gabapentin as mentioned. Tiredness can be to the level of disorientation.

Gabapentin withdrawal symptoms are so uncommon estimates of risk cannot be made. In theory, they could overlap those of alcohol withdrawal. Considering conservative estimates are thousands of patients would be exposed yearly in the US to withdrawal effects and there is almost zero reports and zero deaths... must be lower risk than alcohol.
http://www.ncbi.nlm.nih.gov/pubmed/0000
there are cases... but each time a case is written, the author would look for similar cases and try to make estimates of risk. They never ever find enough data to do that.

Bottom line, I can definitely say there is some significant risk to stopping metoprolol abruptly and it should definitely be lowered gradually under supervision.
Gabapentin withdrawal risk is not as certain. Mostly the problems would be if someone has a predisposition to seizures or maybe with a bad psychiatric history; it isn't very commonly seen and I doubt you have much in the way of predisposing risks, but I cannot recommend stopping it without guidance in your case due to the large number of symptoms you have.

Ok.. benzodiazepine withdrawal. Gosh.. my experience? Why I could say anything about my experience
but....
http://www.ncbi.nlm.nih.gov/pubmed/0000
http://www.ncbi.nlm.nih.gov/pubmed/0000
http://www.ncbi.nlm.nih.gov/pubmed/0000/
http://www.ncbi.nlm.nih.gov/pubmed/0000
and several textbooks on addiction
all say it peaks 5 day on the moderate duration benzodiazepines, and other symptoms and syndromes can occur that seem a bit like withdrawal and these last longer. And there's about nothing about acute withdrawal going longer than 2 weeks unless something very unusual is occurring (long acting drugs, no liver metabolism of the drugs, etc.).
I can get several medical website references on this if needed.

Also, doesn't matter about my experience on the question of your going off of metoprolol. Has to be supervised by someone who is observing you; which I can't do. But I can give the general concensus on the medications which is all in agreement on these points.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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What Causes Heart Palpitations, Nausea And Dizziness Post Benzodiazepine Withdrawal?

Brief Answer: withdrawal doesn't last that long Detailed Answer: IF it is 2 weeks after the last dose of benzodiazepines (probably even Quaaludes), the drug has been out of your system for nearly that whole time. The peak of the withdrawal is 1-5 days after, not 10. ON the other hand.... anxiety disorder occurs when off of anxiety meds and often/usually is worse for weeks after stopping. Addiction, cravings, other disorders can also be occurring. Cannot say in your particular case. and anti-depressants with anti=anxiety effects would usually also be given.