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Benzodiazepine Withdrawal Psychosis

Benzodiazepine Withdrawal Psychosis, Symptoms, Dangers, Duration, Addiction, Dual Diagnosis & Treatment

Benzodiazepine Withdrawal Symptoms

The benzodiazepine withdrawal symptoms are physically and emotionally painful, and can even be life-threatening if the user stops “cold turkey.” Those with a history of taking higher doses or taking the substance for a prolonged time have the worst withdrawal symptoms. Benzodiazepine withdrawal symptoms are highly variable and often come and go during the Benzo detox process. They may vary in severity and frequency throughout all phases of the withdrawal process.

During the Benzo detox process the most common benzo-withdrawal symptoms, often called “rebound” symptoms, usually manifest within one to four days of discontinuing use, depending on the benzo used, the amount of use, and the frequency of use. These symptoms typically last up to ten days and include:

Benzodiazepine Side Effects

  • Sleep disturbances
  • Increased tension
  • Anxiety
  • Panic attacks
  • Difficulty concentrating
  • Excessive sweating
  • Cravings
  • Heart palpitations
  • Headache
  • Muscular stiffness or discomfort
  • Mild to moderate changes in perception
  • Hand tremors

Less common and more severe symptoms can occur as well, especially in cases of severe addiction. These include:

  • Hallucinations
  • Seizures
  • Psychosis or psychotic reactions
  • Increased risk of suicidal ideation

How Long do benzodiazepine withdrawal symptoms last?

Benzodiazepines are not intended to be taken long-term, as prolonged use or abuse can cause the brain to become both physically and psychologically dependent on them. Once Benzo Detox starts, withdrawal symptoms, may begin, ranging from a return of uncomfortable psychological symptoms to physical manifestations such as nausea and diarrhea, which may occur when the drugs are removed from the bloodstream. 

Family history of drug dependency or previous issues with substance abuse and/or dependency may increase the likelihood of developing a dependency on a benzodiazepine and may potentially add to the withdrawal timeline duration as well.

Each benzodiazepine medication has a specific half-life that influences the length of time it takes for the drug to leave the bloodstream. If an individual is dependent on a benzo, once the drug is purged from the body, withdrawal may begin. For shorter-acting benzos like Xanax, withdrawal may start within 10-12 hours of stopping the drug. With a longer-acting benzodiazepine such as Valium, it may take a few days for symptoms to appear. Withdrawal side effects are not generally lethal, although they are best managed with professional medical attention and supervision.

Benzodiazepine Withdrawal Psychosis
Benzodiazepines are not intended to be taken long-term, as prolonged use or abuse can cause the brain to become both physically and psychologically dependent on them.


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Individuals taking benzos for several months or more and in high doses are likely to experience more withdrawal symptoms that last longer than those taking smaller doses for a shorter length of time. For example, the U.S. Food and Drug Administration (FDA) reported that patients taking doses of 4 mg/day or higher of Xanax for longer than three months were more likely to become dependent on the drug and therefore more likely to experience more uncomfortable withdrawal symptoms than those taking smaller doses for less time.

Some short-acting benzodiazepines, like Xanax, are thought to be more potent than some of the longer-acting ones, such as Valium, as well. While withdrawal will be similar for both, users of short-acting benzos may experience withdrawal symptoms sooner and with more intensity, as benzos with longer half-lives will stay in the body longer, therefore slowing the onset of withdrawal. 

Benzodiazepines are all designed as central nervous system depressants; however, they each may work slightly differently at targeting certain symptoms. For example, Restoril, Dalmane (flurazepam), and Halcion (triazolam) are considered primarily hypnotic benzodiazepines prescribed for insomnia, while Xanax, Ativan, Librium (chlordiazepoxide), and Valium are classified as anxiolytics used to treat anxiety symptoms. Klonopin is considered primarily an anticonvulsant.

Different metabolites of these medications make them slightly different, which may also affect how quickly they leave the bloodstream. Withdrawal from different benzodiazepines is generally thought to bring the same general symptoms; however, it is possible that an individual withdrawing from a hypnotic may have more disrupted sleep patterns while withdrawal from an anxiolytic may include higher levels of anxiety.

The method of ingestion is also related to the onset of withdrawal. For instance, snorting or injecting benzos sends the drugs straight into the bloodstream to take almost instant effect. Ingesting a pill requires that it be digested through the digestive tract, which creates a less intense high and slower onset of withdrawal symptoms.

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What Is Psychosis?

Psychosis is an umbrella term used to describe conditions that affect your mind and disconnect you from reality. When a person experiences psychosis or moments of psychosis, these are referred to as psychotic episodes.

Psychosis affects the way your mind processes information. It causes you to lose touch with or disconnect from reality. During a period of psychosis, you may experience disturbing thoughts or perceptions and also have trouble understanding the situation and what’s going on around you.

Common symptoms of psychosis include delusions (false beliefs) and hallucinations (seeing or hearing things that aren’t real). Other symptoms may include incoherent speech or speech that doesn’t make any sense to others and behavior that’s inappropriate for the current situation.

Psychosis is not a condition itself but rather a symptom of other conditions. You may have heard of this word being used in conversations about mental disorders like schizophrenia and bipolar disorder, but it’s also a common condition among drug users.

Benzodiazepine Withdrawal Psychosis
Psychosis is an umbrella term used to describe conditions that affect your mind and disconnect you from reality.

Benzodiazepine Withdrawal Psychosis

While specific mechanisms of action vary from drug to drug, most substances with a potential for abuse and addiction can significantly alter brain function in ways that disrupt perception and cognition. Benzodiazepines are among the many drugs that cause a disturbance in cognition, altering the person’s mental state, slowing their response time, distorting their normal thought processes, and even affecting their memory.

If you’ve ever wondered, “can benzodiazepines cause hallucinations” the answer is yes. Physicians often refer to the sudden onset of symptoms like hallucinations and delusions as “delirium” instead of “psychosis.” “Delirium” refers to a short period of drug-induced delusions and hallucinations, while “psychosis” refers more commonly to a symptom of a mental disorder.

Benzo-induced psychosis can occur when a person takes a large dose of benzos or mixes them with other drugs or alcohol, causing intoxication. However, it’s most common among people who are withdrawing from these drugs.

Benzos work by enhancing the effects of a chemical called gamma-aminobutyric acid (GABA), which is also referred to as an inhibitory neurotransmitter because it blocks messaging between nerve cells to reduce activity in the central nervous system. As a result, a person who takes benzos may experience a sense of relaxation and calm.

However, in large doses and when mixed with other drugs or alcohol, benzodiazepines can affect people so strongly that their thinking slows, their judgment is impaired, and they can rarely understand what’s happening. As intoxication kicks in, delirium progresses into benzodiazepine psychosis, including symptoms like visual distortions, hallucinations, confused thoughts, and paranoia.

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Also referred to as Klonopin withdrawal psychosis, Ativan-induced psychosis, and benzodiazepine-induced psychosis, benzodiazepine withdrawal psychosis or delirium may occur when the use of these drugs is suddenly stopped or reduced.

Stopping benzos without medically monitored detox can be highly dangerous, especially when the person has been abusing them for long periods. Benzodiazepine withdrawal symptoms may include a variety of physical complications, such as high blood pressure, heart palpitations, insomnia, and even seizures.

Additionally, people with existing mental disorders or conditions like insomnia are more likely to experience delirium and other side effects when withdrawing from benzos. Certain benzos are also more likely to produce psychotic symptoms

People who take Xanax, for instance, are at an increased risk of severe withdrawal symptoms, including psychosis. The drug’s short half-life compared to other benzos causes more sudden and intense withdrawal symptoms, making it more difficult for the brain to adjust to the change.

Even people who don’t experience any medical complications from benzo withdrawal may experience benzodiazepine withdrawal psychosis. It’s possible to experience psychosis solely from benzo withdrawal. Research also suggests that the normal administration of benzos can also produce psychosis.

While the specific causes are unknown, some neuroscientists believe that people who abuse or use benzos long-term become accustomed to them and that previously depressed neurons begin firing rapidly once use is stopped. Their brains are so accustomed to a daily “chill pill” that the day it doesn’t receive this medication, it reacts as they did before.

This excited state that the brain jumps into during benzo withdrawal is the opposite of the drug’s side effects, mimicking a state of intoxication. Simply put, benzodiazepine withdrawal psychosis is caused by a sudden increase in the neural activity in the brain when the use of the drug is stopped, which can lead to certain symptoms.

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Benzodiazepine Withdrawal Psychosis Symptoms

Symptoms of benzodiazepine withdrawal psychosis are often different from those of other psychotic disorders, like schizophrenia. These include auditory hallucinations and paranoid delusions.

Although people with benzodiazepine withdrawal psychosis may experience similar symptoms, they tend to develop symptoms that are uncommon to schizophrenic patients – such as visual hallucinations – and also tend to develop more rapidly than symptoms of other psychotic disorders.

Common symptoms of benzodiazepine withdrawal psychosis include:

  • Hearing, seeing, or tasting things that other people don’t
  • Having unusual beliefs or thoughts, no matter what others say or what evidence is presented
  • Reduced hygiene
  • Isolation from friends and family
  • Difficulty thinking clearly or paying attention
  • Auditory hallucinations (hearing voices that aren’t real)
  • Visual hallucinations (seeing people or things that aren’t real or seeing distorted shapes)
  • Delusions or beliefs that don’t align with your culture or don’t make sense to others
  • Feeling as if outside forces are controlling your feelings and behavior (delusion)
  • Giving significant meaning to small events or comments (delusion)
  • Feeling as if you have superpowers or are on a special mission (delusion)

Benzodiazepine withdrawal psychosis hallucinations and delusions can be terrifying and disturbing. The physical symptoms of detoxing from benzos can also be uncomfortable and even dangerous without medical assistance.

It’s important to utilize the help of a benzo addiction treatment and detox to safely overcome withdrawal symptoms and achieve recovery. At We Level Up, we not only offer treatment and detox, but we also provide dual diagnosis treatment to those who suffer from both a mental disorder and addiction and need individualized care that addresses both.

Benzodiazepine Withdrawal Psychosis Duration

Benzodiazepine withdrawal symptoms come and go and usually dissipate after a few days. Most benzo withdrawal symptoms begin within 24 hours after the person’s stopped or reduced their use and can last for several days to several months.

Prolonged withdrawal isn’t uncommon, and many people who abuse benzos may continue to experience withdrawal symptoms even years after they’ve stopped taking them.

When it comes to benzo withdrawal delirium or psychosis, symptoms usually come in stages. First, the person may experience a rebound of anxiety and insomnia within the first one to four days of withdrawal. Then, the psychosis or state of delirium itself may last from 10 to 14 days. Finally, the person may experience another stage of anxiety, which may persist until treatment is received.

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How Long Does it Take to Get Addicted to Benzodiazepines?

Benzodiazepines are prescription drugs that cause long-lasting changes in the brain’s ‘reward system’ when taken for long periods. When a user takes benzodiazepines, they alter the levels of reward-producing natural chemicals, such as dopamine and norepinephrine. Over time, the brain physically adapts so that it is unable to produce these chemicals on its own and becomes reliant on the drugs to feel normal. These effects on the brain can easily lead a person to Benzo Addiction. 

There are well-recognized harms from the long-term use of benzodiazepines. These include dependency, cognitive decline, and falls.

This depends on the drug taken, but it is very possible to become addicted to the first use. Benzos are drugs that act on neurotransmitters in the brain causing feelings of relaxation. First marketed in the 1950s, Benzos were used as a treatment for anxiety and insomnia. They work by binding to GABA receptors in the brain, which inhibits signals to the central nervous system.

How long to get addicted to Benzos, might you wonder? Benzos have a high potential for abuse and addiction because they cause euphoria or calmness when taken at higher-than-prescribed doses, especially when used recreationally to “chill out.” Benzo addiction is using it daily for months to achieve these feelings of relaxation. Benzos should not be taken without a prescription due to the risk of physical dependence and addiction.

Like any drug, the more you take, the stronger the sensations are. However, more than other drugs, benzodiazepines can be the basis of low-level, functioning addictions, where the user treats the drug as a pharmaceutical medication, keeping the levels constantly ‘topped up.

Anyone who has struggled to stop using benzodiazepines will be aware of the serious effects they have on the mind and body. The drugs are designed to affect almost every part of the brain – that is why they are so effective as anti-anxiety medication. But it is also why they can be so difficult to quit. 

Why Are Benzodiazepines Abused?

Benzodiazepines work by literally slowing down the functioning of the brain. They do this by enhancing the actions of a particular chemical in the brain called GABA, or gamma-amino-butyric acid. GABA is a very important part of our brain’s natural sedating mechanism – it sends messages from brain cell to brain cell telling them to slow down or stop firing completely. Normally, it is released in times of high stress and acts as a leveler, allowing us to continue what we are doing without being overcome by anxiety. But when GABA levels are artificially increased by Benzodiazepines, it can lead to several effects, from slurring words to total blackouts.

One of the effects of GABA is the suppression of important natural ‘reward’ chemicals such as serotonin and norepinephrine. This, in turn, causes the increased release of a chemical called dopamine, which causes feelings of calm and contentment. However, when benzodiazepines are used for a long period, the brain responds by reducing the amount of these neurotransmitters it naturally produces, leading to a reliance on the drugs just to feel ‘normal’.

Benzodiazepine Addiction Treatment

Addiction is classed as any pattern of behavior that causes negative consequences for the individual. So if the use of benzodiazepines has started to affect the everyday life of a person negatively, it is likely that they have an addiction. If this is the case, it is imperative to get treatment to regain control of your life.

Benzodiazepine Withdrawal Psychosis
Benzodiazepine withdrawal psychosis hallucinations and delusions can be terrifying and disturbing. The physical symptoms of detoxing from benzos can also be uncomfortable and even dangerous without medical assistance.

Treatment may include a program of detoxification and rehabilitation. The person may or may not be prescribed a substitute drug to help with the withdrawal from the medication. Included may be a combination of the following treatments and therapies:

To overcome an addiction to benzodiazepines, a detox will likely be necessary; this could potentially lead to a range of unpleasant withdrawal symptoms. It is not recommended for a person suffering from Benzo Addiction to stop taking the medication abruptly as this can lead to severe symptoms.

During a detox, experienced staff will ensure you are comfortable and safe at all times and will monitor your progress while administering appropriate treatment. You may be advised to reduce your benzodiazepine consumption over the course of a few days until you are able to quit completely. You might be provided with a substitute drug to help prevent the worst symptoms from occurring.

Because of the severity of benzodiazepine withdrawal symptoms, users generally start their recovery by gradually reducing their dosage. For most users, this can be done over the course of a few weeks, though for those on a high dosage the process may take longer. This is designed to wean the client off the drug as safely and comfortably as possible. Since the effects of the withdrawal can be painful and traumatic even when the dosage is tapered off, the client may be prescribed anti-anxiety and anticonvulsant medication to help them through the process. 

Reclaim Your Life From Benzodiazepine Withdrawal Psychosis

Benzo addiction is a condition that can cause major health, social, and economic problems that should not be taken lightly. We Level Up rehab treatment & detox center can provide you, or someone you love, the tools to recover from benzo addiction with professional and safe treatment. Feel free to call us to speak with one of our counselors. We can inform you about this condition by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.

Sources

[1] NIH – Hallucinations after a therapeutic dose of benzodiazepine hypnotics with co-administration of erythromycin
[2] NIH – The benzodiazepine withdrawal syndrome
[3] Brett, J., & Murnion, B. (2015). Management of benzodiazepine misuse and dependence. Australian prescriber. (Ncbi.nlm.nih.gov)