Sedative, Hypnotic, Or Anxiolytic Withdrawal

Withdrawal from sedatives, hypnotics, or anxiolytics can cause various physical, psychological, and behavioral symptoms. While these symptoms can vary in severity and duration, certain symptoms may occur more commonly than others. Some of these symptoms can be similar to those experienced during alcohol withdrawal or other substance use withdrawal.

Physical symptoms

Withdrawal from sedatives, hypnotics, or anxiolytics can cause physical symptoms, which may include:

• Tremors or shakiness
• Nausea or vomiting
• Sweating or chills
• Rapid heart rate or palpitations
• High blood pressure
• Muscle tension or pain
• Headaches
• Dizziness or light-headedness
• Seizures (in severe cases)

Physical symptoms can be particularly severe in the case of benzodiazepines, a type of sedative that can cause dangerous withdrawal symptoms, such as seizures, if discontinued abruptly. 

Psychological symptoms

Psychological symptoms can be some of the most distressing aspects of withdrawal from sedatives, hypnotics, or anxiolytics. These may include:

• Anxiety or panic attacks³
• Depression
• Irritability or agitation
• Mood swings
• Confusion or disorientation
• Hallucinations⁴ or delusions⁵ (in severe cases)

Many people use these substances to manage anxiety or insomnia, so the withdrawal process may cause a temporary worsening of these conditions.

Behavioral symptoms

Withdrawal from these substances can also cause behavioral symptoms, which may include:

• Insomnia or difficulty sleeping
• Restlessness or agitation
• Changes in appetite
• Social withdrawal or isolation
• Impaired concentration or memory

These behavioral symptoms can further contribute to the distress and discomfort experienced during the withdrawal process. Withdrawal symptoms can be severe and may require medical attention. Seizures, for instance, can be life-threatening and require immediate medical intervention. Similarly, severe psychological symptoms like hallucinations or delusions may indicate the need for psychiatric help.

Sedative, hypnotic, or anxiolytic withdrawal is caused by the abrupt cessation or reduction of these substances after prolonged use. The body typically becomes accustomed to the presence of these drugs and adapts its functioning accordingly. When the substances are suddenly reduced or removed, the body may struggle to readjust, leading to withdrawal symptoms.

Several factors may contribute to the risk of experiencing withdrawal symptoms from these substances:

• Duration and frequency of use: Prolonged use of sedatives, hypnotics, or anxiolytics can increase the likelihood of withdrawal. The body typically becomes more reliant on such substances to function normally, and abrupt cessation can lead to a more severe withdrawal.
• Dosage: Higher doses of these substances tend to increase the risk of withdrawal symptoms. Those who use large amounts of these substances may be more likely to experience withdrawal when they stop using them.
• Individual differences: Factors like age, health, metabolism, and genetic predisposition may influence the severity and duration of withdrawal symptoms.
• Polysubstance use: Using multiple substances, such as sedatives, alcohol, or opioids, can increase the risk and severity of withdrawal symptoms.
• Method of cessation: Abruptly stopping the use of sedatives, hypnotics, or anxiolytics can lead to more severe withdrawal symptoms than gradually reducing the dosage.

Treatments for sedative, hypnotic, or anxiolytic withdrawal typically aim to manage the uncomfortable and possibly dangerous symptoms that occur when someone stops using these substances after a period of dependence. A comprehensive treatment plan may include therapy, medication, self-care strategies, and other support options.

Medication

Medication can be used to manage withdrawal symptoms. Benzodiazepines may be tapered gradually under medical supervision to avoid severe withdrawal symptoms. Sometimes, a substitute medication with less severe withdrawal symptoms may be prescribed and then also tapered gradually. 

Anti-anxiety medications may be used to manage psychological symptoms of withdrawal. Antipsychotics or antidepressants may be prescribed for more severe symptoms. It is recommended that individuals experiencing withdrawal only use medications under the guidance of a healthcare professional. Do not start, stop, or change medications without first consulting with your physician or another qualified health professional.

Other treatment options

In some cases, especially for those with severe withdrawal symptoms, inpatient or residential treatment may be recommended. These programs provide a structured and supportive environment where individuals can focus on recovery without external triggers. Outpatient treatment options, including day programs and intensive outpatient programs (IOPs), typically offer flexibility for people who still need to continue their daily lives while receiving support and treatment.

Self-care

Self-care strategies can be beneficial for maintaining long-term recovery. These might include:

• Eating a balanced diet: Proper nutrition can help the body recover from the effects of substance use and improve overall well-being.
• Getting regular exercise: Physical activity may help alleviate withdrawal symptoms, reduce stress, and boost mood.
• Prioritizing sleep: Sleep disturbances can be common during withdrawal, so establishing a healthy sleep routine may help with recovery.
• Engaging in enjoyable activities: Participating in hobbies or other activities may help distract from cravings and improve mood.
• Building a support network: Connecting with friends, family, or support groups can provide encouragement and help prevent relapse.

Withdrawal from sedatives, hypnotics, or anxiolytics can be challenging and potentially dangerous. Medical supervision and support are often essential during the withdrawal process.

For those experiencing sedative, hypnotic, or anxiolytic withdrawal, therapy can be a valuable resource to help manage symptoms and address the underlying causes of substance use. Those who feel hesitant to discuss substance use in traditional in-person therapy may benefit from online therapy, which allows individuals to connect with a licensed therapist via audio, video, or live chat from the comfort of their home.

In addition to therapy, there are several resources available for individuals living with sedative, hypnotic, or anxiolytic withdrawal:

• The Substance Abuse and Mental Health Services Administration (SAMHSA) provides a National Helpline (1-800-662-4357 [HELP]) that offers information and referrals for treatment and support services.
• The National Institute on Drug Abuse (NIDA) offers evidence-based information on substance use and treatment, as well as resources for finding treatment providers. You can also find scientific research on addiction and comprehensive guides for managing withdrawal.

Finally, there are several support groups available online for individuals in recovery from addiction. These groups typically offer a safe and supportive environment to share stories, advice, and encouragement. Relapse and prevention are common topics of discussion. Some examples of support groups include SMART Recovery and Narcotics Anonymous. Church and faith-based organizations may also provide support. 

No matter what stage of recovery you're in, there is help available. You can start exploring these resources for more information and support on managing sedative, hypnotic, or anxiolytic withdrawal. With the right treatment plan and professional guidance, you can make the changes necessary for a successful recovery.

Emerging research on the treatment and causes of sedative, hypnotic, or anxiolytic withdrawal is shedding new light on the mechanisms underlying withdrawal symptoms and potential treatment approaches.

In a study published in PLoS ONE in 2023, researchers conducted a survey of over 1,200 benzodiazepine users. More than 50% of participants who experienced neurological symptoms, such as nervousness, anxiety, and distractedness, stated that their symptoms lasted for more than a year. Some researchers have proposed use of the term benzodiazepine-induced neurological dysfunction (BIND) for this condition. Further research may provide clarity on the risk of BIND symptoms as well as treatments to reduce symptoms.

Another study published in 2022 looked at the use of focused counseling for individuals facing benzodiazepine withdrawal. The study states, “Following counselling, 88% of participants reported either reduced use or withdrawal from benzodiazepines.” The participants responded well to medically supervised tapering combined with focused counselling. 

Despite these advances, more research is needed to understand the mechanisms underlying sedative, hypnotic, or anxiolytic withdrawal and to develop more effective treatment strategies.

Below are some statistics on sedative, hypnotic, or anxiolytic withdrawal:

• Withdrawal symptoms from sedatives such as barbiturates and benzodiazepines typically manifest between two to 10 days after discontinuation of the drug.
• One study found that 30.6 million adults in the United States reported past-year benzodiazepine use. 
• A study published in 2022 found that “use of a prescription opioid increased the odds of using a sedative-hypnotic 4-fold in the past year, whereas misuse of an opioid was associated with a greater likelihood of sedative-hypnotic use.”
• Cognitive behavioral therapy (CBT) may help increase rates of benzodiazepine abstinence in those with insomnia or anxiety disorders to 70%-80%.