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How To Come Off Benzodiazepines Intake?

Posted on Tue, 1 Apr 2014

Question: I have suffered from anxiety disorder for years and have been prescribed (over-prescribed, I think) benzodiazepines. I really would like to get off these things. I live in a rural area where psychiatrists are few and far between. Can you offer suggestions?

Answered by Dr. Srikanth Reddy (23 minutes later)

Brief Answer: Benzodiazepines are not the solution Detailed Answer: Hello, Thanks for choosing health care magic for posting your query. I have gone through your question in detail and I can understand what you are going through. Anxiety disorders occur cause of the imbalance among the neurotransmitters in the brain. That needs to be corrected primarily with antidepressants like escitalopram or paroxetine or mirtazapine or venlafaxine. These drugs can be augmented with benzodiazepines in the initial phases until the above mentioned drugs start showing their effects. Taking benzodiazepines exclusively for anxiety disorder is like cosmetic correction of a wound. It doesnt heal the wound. Further it would be wise to augment your current medical treatment with cognitive behavioural therapy. This therapy involves identification of irrational thoughts and then practising a different way of thinking. It coukd be some 8-10 20 min sessions. I understand that there are few psychiatrists in your area but you should discuss these issues with your GP or psychiatrist who can then help you with the prescriptions for the above mentioned drugs. Believe me its worth as it will change your quality of life a lot. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: bit.ly/dr-srikanth-reddy Wish you good health, Kind regards Dr. Srikanth Reddy M.D.

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

Follow up: Dr. Srikanth Reddy (1 hour later)

I understand. My problem at this point is getting off the benzodiazepines. My understanding is that withdrawal is not only difficult but XXXXXXX up to and including Grand Mal seizures and death. My physician has told me, frankly, that he is not up to dealing with such issues. I have read that withdrawal requires a gradual taper off the "benzos". But that requires a long-time and more prescriptions. An inpatient program for such a problem could take a year. I'm not prepared to deal with that. In fact, no inpatient program will work for me as I'm the primary care-giver for an ailing wife. I guess my solution is to find a psychiatrist experienced in this kind of problem. Would you agree?

Answered by Dr. Srikanth Reddy (6 hours later)

Brief Answer: Clarifications Detailed Answer: Hello Before I proceed to answer your questions about benzodiazepine dependence, let me know what are the actual medications that you are consuming and in what dosage per day. That would help me in tailoring the answer specifically for you. Regards Dr. Srikanth Reddy MD

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

Follow up: Dr. Srikanth Reddy (55 minutes later)

Thank you for your help. I am stabilized at 2mg Xanax in the morning and 10 mg Valium in the evening. There are extremely stressful days (a plane trip, for example), when the dosage goes to considerably more than that but never more than a total of, say a daily total of 40mg of Valium or (not and, but or) a daily dose of 8mg of Xanax. Those days are rare--perhaps once every month or six weeks. Infrequently, the daily dosage may exceed the standard of 2mg Xanax and 10mg Valium over a two or three day period to twice the standard dose (to, say, 4mg Xanax and 20mg Valium). These will occur under prolonged stress (when wife is in hospital, for example, and I am out of town with her). That may occur a couple of times a year. I almost never feel drowsy or "sedated", even if on higher dosages and am never what I would consider to be "high" but remain functional.

Answered by Dr. Srikanth Reddy (14 minutes later)

Brief Answer: This will require inpatient treatment Detailed Answer: Hello Thanks for the add on information. The dosages that you have stated can be withdrawn gradually on Out patient basis as well and it will not take more than 3 weeks to taper it of on out patient basis. IN indoor care setup it would not take more than 2 weeks. If it is tapered properly the risk of seizures is almost negligible and death is a very very very rare chance. Dont be so pessimistic. It would be advisable to get admitted. But if the social situation doesnt permit you then the tappering can be done on OPD basis as well. IT safe to get that done. Regards Dr. Srikanth Reddy MD

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