Weaning off BENZODIAZEPINES After Long-Term Use By Dr Sadaf Cheema GPST2.

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Presentation transcript:

Weaning off BENZODIAZEPINES After Long-Term Use By Dr Sadaf Cheema GPST2

Benzodiazepines a group of medications which have been used since the 1960s to treat: anxiety epileptic seizures mania, alcohol withdrawal sleeping problems

How do they work? They boost the effect of a substance in the brain called – GABA. GABA is a neuro- transmitter – a chemical which is used in the brain to control the passage of impulses from one cell to another. GABA has a generally calming effect in the human brain.

What are the main side effects? Sleepiness Unsteadiness Memory problems.

Benzodiazepines withdrawals Continuous use of 6 weeks get withdrawal symptoms difficulty in sleeping, feeling tense, agitated dizziness, metallic tastes, and disturbances of vision. Sometimes with severe withdrawal they produce confusion, hallucinations and epileptic fits. Some people experience unpleasant symptoms for several months afterwards. Withdrawals will usually start within 48 hours of stopping or reducing the dose of a benzodiazepine. They can be mild and pass off within a few days

Managing withdrawal If Benzodiazepine are used continuously for more than 3 weeks or so ----should not be stopped suddenly. Most people withdraw from them gradually by reducing the daily dose every 2-4 weeks, by an 1/8 or a 1/4. It is better to reduce too slowly rather than too quickly. Lorazepam, are harder to come off than others. Sometimes in difficult situation, switch over lorazepam to Diazepam which is easier to come off. 1mg of Lorazepam is roughly equivalent to 5-10mg of Diazepam.

Blood tests Benzodiazepines are very safe and no routine tests are needed before taking them.

Other Helps: Self-help treatments for anxiety and insomnia (psychologists, books, internet) Psychological therapies and/or antidepressants are needed in the longer term. Sleeping well Cognitive behaviour therapy

Any Questions ?