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Coming off benzodiazepine tranquillisers or sleeping pills
Warning: “Cold turkey” withdrawal (stopping benzodiazepines completely all at once) is strongly advised against. It is possible to have a withdrawal seizure or fit as a result of “cold turkey”. Stopping all at once often means the person can be overwhelmed with severe withdrawal symptoms. As the pain and distress is unbearable, the person will usually start taking benzodiazepines again, which can result in a sense of failure, or a fear of going through withdrawal again.
It is recommended that people taking benzodiazepines who wish to come off the drugs reduce the dose by small amounts rather than stopping completely even after only a few weeks of benzodiazepine use.
A slow reduction program from the drugs allows the body and mind to slowly adjust to each level and gradually return to normal functioning.
Making the decision
Although the withdrawal period may be distressing and protracted, there are good reasons for coming off benzodiazepines:
- Not everyone experiences difficult withdrawal
- The drugs are unlikely to be effective any more
- The long term use of the drugs may be making you feel worse
- The side effects of the benzodiazepines can be seriously disabling e.g. falls
- There are often subtle effects of the benzodiazepines which become clear once you are off the drugs, such as irritability, tiredness and memory problems
- The longer you continue taking the benzodiazepines, the more likely you are to become dependent
- Many people who are dependent are already experiencing “break through” withdrawal, with significant effects both physically and mentally
- Long term use of the benzodiazepines can make anxiety worse
- Long term use of the benzodiazepines worsens the quality of sleep
Reducing the dose
Before reducing benzodiazepines, it is most important to talk this over with your doctor and ensure you have her or his support. Your doctor will be able to provide scripts for smaller doses of the drugs and will be able to check if symptoms are indeed withdrawal and not some other condition.
The support of a counsellor with expertise in benzodiazepine withdrawal support is very useful but not always available. Reconnexion provides a telephone support and information service. Mon- Fri 9am – 5pm
The usual procedure for reduction is
- Stabilise on a normal daily dose and ensure that the dose is taken regularly throughout the day
- Change a short or medium acting benzodiazepine to a long acting one such as diazepam (an exception may be with older people where drug accumulation could be problematic)
- Reduce a small amount of one dose ( a guide is 10-20% of the overall dose)
- Stabilise on the reduced amount for at least two weeks
- Reduce again
- Take “rests” during the reduction process if the symptoms become too severe or during a stressful time.
Detailed advice on how to reduce can be found in the booklet “Step by Step guide to reducing benzodiazepines and recovery from withdrawal” to be found in the Resources section. Another useful booklet in the Resources section is Professor Heather Ashton’s manual “Benzodiazepines- How they work and how to withdraw”.
Professor Ashton’s manual can be downloaded here. | 
