Chronic use of benzodiazepines (such as  Xanax, Lexotanil, Tavor or Dorm, Clonotril, etc.) and hypnotics (such as  Silnox, Imovane), although offering relief from anxiety and insomnia in the early days, usually leads to a number of major problems, including worsening of mental symptoms.

Despite their initial effectiveness, long-term use increases the body’s tolerance, necessitating larger doses to achieve the same effect.

This inevitably leads to dependence and addiction. In addition, abruptly stopping or reducing the dose may cause severe withdrawal symptoms. They include increased anxiety, depression, even seizures, and may not be directly perceived as being associated with the reduction or cessation of. It is not uncommon for such symptoms to be misinterpreted as a genuine need for the drug. This can unfortunately trap a person in a difficult vicious cycle, making it more challenging to treat the original disorder.

Challenges of chronic use

• Dependence and addiction: long-term use can lead to physical and psychological dependence.
• Tolerance: over time, larger doses are required to achieve the same effect.
• Symptoms of withdrawal: Discontinuing use can cause severe withdrawal symptoms, such as anxiety, insomnia, and convulsions.
• Mental disorders: Increased risk of depression, anxiety and cognitive dysfunction.
• Physical problems: Balance problems, falls, and increased risk of traffic accidents.

Symptoms

• Psychological: Anxiety, depression, irritability, and psychomotor agitation.
• Physical: Tremors, muscle twitching, insomnia, hyperpyrexia and sweating.
• Mental: Memory disorders, difficulty concentrating, and confusion.

Rehabilitation Options

Gradual Dose Reduction (Tapering)

• Gradual dose reduction based on a tailored schedule, usually with a substitute and regular psychiatric supervision to minimise withdrawal symptoms.

Medical Support:

• Medication: Use of medications to manage withdrawal symptoms.
• Medical Monitoring: Regular evaluation and adjustment of treatment by a health professional.

Psychotherapy

• Cognitive-Behavioral Therapy (CBT): helps to treat anxiety and other psychological issues without drugs.
• Supportive Psychotherapy: Provides emotional support and strategies for managing withdrawal.

Alternative therapies:

• Relaxation techniques: Meditation, yoga and other stress management practices.
• Dietary supplements: Certain supplements may help manage withdrawal symptoms.

Continued reliance on sedative and hypnotic drugs is not a viable solution for treating disorders such as anxiety and depression, as it can lead to serious side effects and complications. Long-term use of these drugs induces tolerance, with the result that patients need increasingly higher doses to achieve the same effect, thus increasing the risk of addiction and overdose.  

In addition, continued use usually  worsens the symptoms that these drugs were originally trying to relieve, such as feeling tired, restlessness, psychomotor slowing, and sleep disturbances. With gradual dose tapering and the support of a comprehensive treatment program, patients can regain control of their lives and find healthier and more effective ways to manage anxiety and depression.

At our clinic, we offer a specialized program of sedative and hypnotic drug rehabilitation designed to help people regain their health and autonomy safely and effectively. This program is based on the gradual reduction of medication dosage, which is done under strict supervision. By incorporating substitute medications during the tapering process, we can minimize withdrawal symptoms and support patients in the process of rehabilitation.

Along with pharmaceutical support, our program includes psychological therapy that focuses on the underlying causes of addiction. Through individual sessions, patients gain the tools and skills they need to cope with challenges and prevent relapse. Our approach is holistic, recognizing that addiction affects multiple aspects of people’s lives and requires a comprehensive approach to achieve long-term recovery and improved quality of life.

Bibliography:

• Ashton, H. (2005). the diagnosis and management of benzodiazepine dependence. current opinion in psychiatry, 18(3), 249-255. 

• Lader, M. (2012). benzodiazepine harm: how can it be reduced? British Journal of Clinical Pharmacology, 77(2), 295-301.

• Nutt, D. J., & Malizia, A. L. (2001) New insights into the role of the GABA(A)-benzodiazepine receptor in psychiatric disorder, The British Journal of Psychiatry, 179(5), 390-396. 

• Rickels, K., & Rynn, M. (2013). pharmacotherapy of generalized anxiety disorder. journal of clinical psychiatry, 62(2), 23-29. 

• Voshaar, R. C., Gorgels, W. J., Mol, A. J., van Balkom, A. J., van de Lisdonk, E. H., van den Hoogen, H. J., … & Zitman, F. G. (2003). tapering off benzodiazepines in long-term users with or without group cognitive-behavioural therapy: three-condition, randomised controlled trial. the British Journal of Psychiatry, 182(6), 498-504.