The deceased presented to the hospital with hypertension, elevated temperature, worsening bizarre behavior, and movement irregularities. [ncbi.nlm.nih.gov]

The molecular effects of long-term benzodiazepine exposure are reviewed and a model is presented that draws on results from a number of research groups working in this area. [doi.org]

• Nightmare

  During withdrawal, all patients had severe reactions including anxiety, sleep disturbance, rage reactions, hyperalertness, increased nightmares, and intrusive thoughts; and 6 of the 8 patients had homicidal ideation. [ncbi.nlm.nih.gov]

  Seizures - Loss of interest in people and things - Pupils of eyes become minute - Iris in eyes changes colour - Agoraphobia - Feeling of vulnerability - Feeling of extreme cold - Extremely nervous and jumpy - Muscle wastage - Impotence - Unable to walk - Nightmares [benzo.org.uk]

  Dilara Seyidova Khoshknabi, Sleep Problems and Nightmares, Palliative Medicine, 10.1016/B978-0-323-05674-8.50180-8, (965-972), (2009) ., Depressants, Drug and Alcohol Abuse, 10.1007/0-387-25733-0_2, (41-67), (2006). MELINDA J. BARKER, KENNETH M. [doi.org]

• Hypothermia

  […] possible dose per kg of each drug Co-ingestants e.g. paracetamol Examination CNS depression Neurologic – confusion, dysarthria, nystagmus, lethargy, ataxia, areflexia, hypotonia, seizure Respiratory – depression Cardiovascular – hypotension Metabolic – hypothermia [rch.org.au]

  […] suggested that a presumptive diagnosis of WE should be made for any patient with a history of alcohol dependence who shows one or more of the following: evidence of ophthalmoplegia, ataxia, acute confusion, memory disturbance, unexplained hypotension, hypothermia [doi.org]

• Nausea

  […] blood pressure and anxiety scores), only the experimental group showed considerable changes in physiological measures, participant ratings (e.g., increased ratings of dizziness, blurred vision, heart pounding, feelings of unreality, pins and needles, nausea [ncbi.nlm.nih.gov]

• Hypotension

  Abstract The symptoms include, by ascending order of severity: nightmares and insomnia, nausea and vomiting, muscular weakness or tremor, postural hypotension, hyperthermia, muscle twitching, convulsions, confusional state or psychosis. [ncbi.nlm.nih.gov]

  Although rare, this may result in hypotension, cardiac dysrhythmias, lactic acidosis, seizures, or coma. [emedicine.medscape.com]

  Rationale 54: Adverse effects of chloral hydrate are most common in infants younger than 6 months, including apnoea, desaturation, hypotension, vomiting, and prolonged sedation (Ratnapalan 2014). [gosh.nhs.uk]

  Calculate the maximum possible dose per kg of each drug Co-ingestants e.g. paracetamol Examination CNS depression Neurologic – confusion, dysarthria, nystagmus, lethargy, ataxia, areflexia, hypotonia, seizure Respiratory – depression Cardiovascular – hypotension [rch.org.au]

  Drowsiness Dizziness Decreased alertness Poor concentration Lack of coordination, falls and injuries (especially in the elderly) Decreased libido and sexual performance problems Nausea Blurred vision Euphoria Nightmares Changes in appetite Depression Hypotension [promises.com]

• Motor Restlessness

  […] onset and motor restlessness exacerbated by relaxation. [pubmedcentral.nih.gov]

• Muscle Weakness

  They are widely acknowledged to be very uncomfortable and potentially dangerous and include symptoms such as: Flu-like symptoms like muscle weakness or muscle pain. Shaking. Severe anxiety or panic attacks. Stomach pain and cramping. [luxury.rehabs.com]

  Common symptoms of post-acute benzodiazepine withdrawal include insomnia, medically serious anxiety, medically serious depression, a ringing in the ears called tinnitus, muscle pain, abnormal muscle weakness, episodes of uncontrolled muscle shaking, painful [drugaddictiontreatment.com]

• Sweating

  Withdrawal symptoms may include: abdominal cramps agoraphobia (fear of crowded places) increased anxiety physical symptoms of anxiety (muscle tension, tight chest, palpitations, fast heartbeat, sweating, trembling or shaking) blurred vision depression [mind.org.uk]

  Objective assessment of sweating, restlessness (pacing), and tremor are also documented. A tally of points based on responses and observation can be used to determine treatment. [essentialsofcorrectionalnursing.com]

  Abstract Physiological dependence on benzodiazepines is accompanied by a withdrawal syndrome which is typically characterized by sleep disturbance, irritability, increased tension and anxiety, panic attacks, hand tremor, sweating, difficulty in concentration [ncbi.nlm.nih.gov]

  Withdrawal symptoms of benzodiazepine use include: Restlessness Insomnia Severe stomach upset Vomiting Goose bumps Muscle and bone pain Involuntary movements Agitation Anxiety Sweating Cramping Seizures Psychosis Pupil dilation Mood disturbance Intense [castlecraig.co.uk]

• Fear

  Double vision - Sore and tired eyes - Blurred vision - Screwing up of the eyes - Panic attacks - Fear of being alone - Tiredness - Tension between the eyes - Dizziness - Agitated sight - loss of control of the movement of the eyes - Brain moving within [benzo.org.uk]

  TIP 5: No matter how much fear, anxiety and panic you have in withdrawal, know that once your brain heals, it will fade away. The amount of fear you feel in the depths of withdrawal is not the way you will feel the rest of your life. [prescription-drug.addictionblog.org]

  Ripley, Impaired fear conditioning but enhanced seizure sensitivity in rats given repeated experience of withdrawal from alcohol, European Journal of Neuroscience, 14, 12, (2023-2031), (2002). Pedro V. Rada and Bartley G. [dx.doi.org]

• Euphoria

  They are also popular for self-medicating or abuse purposes; providing peace and euphoria for troubled individuals. They are rarely abused alone and often combined with alcohol or opiates. [essentialsofcorrectionalnursing.com]

  Benzodiazepines produce sensations of euphoria, sedation, calmness, and general sedation. Although they are often prescribed for various disorders, most abusers do not have a prescription for them. [treatment4addiction.com]

  — New York Times, "Watching ‘Euphoria,’ Two Young Recovering Addicts Saw Themselves," 24 June 2019 Sometimes doctors will also prescribe medications known as benzodiazepines like diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin) to reduce [merriam-webster.com]

  Lethargy Loss of appetite Nausea Slurred speech Stuttering Tremors Vertigo Vision changes Vomiting When taking high doses of benzodiazepines, such as with abuse, you can also experience mood swings, hostile or irregular behavior, slowed reactions, and euphoria [drugrehab.org]

  They are often abused for their relaxing and calming qualities which at high doses can cause a feeling of euphoria. [addictionresource.com]

• Depersonalization

  […] and anxiety extremely problematic, especially if the individual has never struggled with these disorders before, but the psychotic symptoms, hallucinations, and depersonalization can all create extremely risky or aggressive behavior that could cause [addictions.com]

  Signs of benzodiazepine addiction usually include irregular sleep schedule, depersonalization, and irritability. Benzodiazepine Withdrawal Treatment Possibly the biggest hurdle for a benzo addict to overcome is the detox. [treatment4addiction.com]

  […] withdrawal syndrome associates the resurgence of the pre-existing anxiety symptoms and new symptoms as sensory disturbances (metallic taste, hyperosmia, cutaneous exacerbated sensitivity, photophobia...) nausea, headache, motor disturbance in some rare cases depersonalization [ncbi.nlm.nih.gov]

  We experience: fear terror debilitating panic Derealization and depersonalization are common withdrawal symptoms, as well. [prescription-drug.addictionblog.org]

  2015 an endoscopic ultrasound showed I had damage and was diagnosed with chronic pancreatitis ), bad bloat and gas (aka benzo belly), ear fullness/popping, weird stools, constipation alternating with loose yellow stools, food sensitivities, brain fog, depersonalization [hormonesmatter.com]

• Visual Hallucination

  On admission he manifested signs of an acute organic brain syndrome with disorientation, urinary and faecal incontinence, visual and tactile hallucinations. [benzo.org.uk]

  Within 24 h after discontinuation they showed signs of (visual) hallucinations, irritability, confusion, restlessness/agitated behavior and generalized convulsions. These are all manifestations of CNS overstimulation. [doi.org]

• Psychiatric Symptoms

  Despite improvement in drinking, there was no significant change in psychiatric symptoms rated with PANSS. [doi.org]

• Insomnia

  Insomnia and depression are frequently encountered in patients during withdrawal from substances. [ncbi.nlm.nih.gov]

  Mid Withdrawal: Progressing to include tremor, fever, diaphoresis, insomnia, anorexia, and diarrhea. [essentialsofcorrectionalnursing.com]

  MEDICATIONS FOR THE TREATMENT OF INSOMNIA Sedatives and Hypnotics Insomnia is an extremely common complaint. [pubmedcentral.nih.gov]

• Agitation

  Frequently, midazolam is also used as an injection or infusion for the treatment of agitation in ventilator-dependent patients. [ncbi.nlm.nih.gov]

• Headache

  Withdrawal can include pain, agitation, restlessness, shakiness, anxiety, headaches, cramps, dizziness, nausea, vomiting, trouble sleeping, and diarrhea, among many others. [fairview.org]

  Over the past year she developed headaches, dizziness and muscle cramps if she missed her regular diazepam and she had increased her dose to 5mg four times a day. [benzo.org.uk]

  Symptoms may include sleep disturbances, increased anxiety, irritability, headache, muscle pain and stiffness. Acute symptoms may resolve after a few months; however, in some cases symptoms may persist for years. [patientslikeme.com]

  […] treatment but in an exacerbated from; the withdrawal syndrome associates the resurgence of the pre-existing anxiety symptoms and new symptoms as sensory disturbances (metallic taste, hyperosmia, cutaneous exacerbated sensitivity, photophobia...) nausea, headache [ncbi.nlm.nih.gov]

• Irritability

  The CIWA-B is a 22-item instrument that monitors type and severity of benzodiazepine withdrawal symptoms such as irritability, fatigue, appetite, and sleeplessness. [essentialsofcorrectionalnursing.com]

  Common symptoms of benzodiazepine withdrawal include: Irritability Anxiety Insomnia Depression. [treatment4addiction.com]

  Symptoms in these patients are mostly agitation, irritability, anxiety, insomnia, tachycardia, hypertension, and sweating. [doi.org]

  Symptoms may include sleep disturbances, increased anxiety, irritability, headache, muscle pain and stiffness. Acute symptoms may resolve after a few months; however, in some cases symptoms may persist for years. [patientslikeme.com]

  This can result in a prolonged protracted withdrawal syndrome characterized by irritability, paresthesias, cognitive impairment, insomnia, and dysphoria, increased sensitivity to sound and light and even psychosis. [benzo.org.uk]

• Sleep Disturbance

  The abstinence syndrome is partially characterized by anxiety, dysphoria, sleep disturbances and other unspecific symptoms. [ncbi.nlm.nih.gov]

[…] antidepressants Chest radiograph, if respiratory compromise is present Pregnancy test, in women of childbearing age In cases of intentional overdose, measure the following: Serum electrolytes Glucose BUN Creatinine clearance Ethanol level Acetaminophen level See Workup [emedicine.medscape.com]

Long-term outcomes for a cognitive-behavioral treatment group and a treatment-as-usual group were measured. RESULTS: BZ discontinuation treatment outcomes were maintained in both treatment groups. No between-group differences were found. [ncbi.nlm.nih.gov]

Anticonvulsants and antidepressants seem to reduce the intensity of benzodiazepine withdrawal and to enhance long term prognosis of dependence. [ncbi.nlm.nih.gov]

The possible biochemical and neuropsychological mechanisms involved in the etiology and maintenance of this condition are reviewed. [ncbi.nlm.nih.gov]

The possible biochemical and neuropsychological mechanisms involved in the etiology and maintenance of this condition are reviewed. Related Topics Loading Related Articles [doi.org]

MEASUREMENTS: Urine BDZ; self-reported Pittsburgh Sleep Quality Index (PSQI) and the Center for Epidemiologic Studies Depression (CES-D) questionnaires administered at baseline, and at 6, 7 and 13 weeks. [ncbi.nlm.nih.gov]

Because such effects are often not recognized by clinicians, accurate epidemiologic data on their incidence are not available. [doi.org]

The following update gives recent research results on the withdrawal pathophysiology and practical information in order to treat or prevent benzodiazepine withdrawal syndrome. [ncbi.nlm.nih.gov]

Pharmacotherapy: A Pathophysiologic Approach, 9th edition. Chapter 53: Anxiety Disorders I; Generalized Anxiety, Panic, and Social Anxiety Disorders. Access Pharmacy [online]. DiPiro et al. Pharmacotherapy: A Pathophysiologic Approach, 9th edition. [rxlist.com]

This pharmacology lecture covers topics such as pathophysiology of anxiety and insomnia, role of GABA in the central nervous system, structure and function of GABA-A receptor, limbic system, mechanism of action and side effects of benzodiazepines, barbiturates [youtube.com]

Pathophysiology Although the precise pathophysiological mechanisms of NMS are unproven, antipsychotic-induced dopamine blockade likely plays a pivotal triggering role in the condition ( Figure 1 ) (21). [doi.org]

Flumazenil, given 24h prior to the measurements, prevented both the sensitivity changes and benzodiazepine tolerance in vivo. The anxiety and decreases in seizure threshold during withdrawal were also prevented. [ncbi.nlm.nih.gov]

Google Scholar [3] Cavazzutti G.B. : Prevention of febrile convulsions with dipropylacetate (Depakine). Epilepsia 16: 647–648, 1975. PubMed Google Scholar [4] Chu N-S. : Carbamazepine: Prevention of alcohol withdrawal seizures. [dx.doi.org]