Withdrawal Flashcards
after 6months of benzodiazepines, what % of patients will experience withdrawal symptoms ?
30%
how long after stopping benzos will symptoms start?
1-2 weeks
what symptoms are seen 1-2 weeks after stopping benzos?
anxiety, psychotic symptoms
what symptoms are seen 1-2 months after stopping benzos?
depression, insomnia, panic
what neurological condition can be mis diagnosed during benzos withdrawal?
MS
- diplopia, paraesthesia, fasciculation, ataxia
how to withdrawal benzos?
stress cons of continuous treatment
withdrawal is harder on short acting benzos so better to switch to diazepam
agree a contract to supply weekly supply and not to add to this
withdraw by 2mg/week of diazepam
warn to expect symptoms and not to be alarmed
what is a complication of stopping antidepressants ?
discontinuation syndrome
how long should an antidepressant be decreased until it is stopped?
4 weeks
- except fluoxetine which doesn’t require a withdrawal regimen since it has a long half life
how long after stopping medication does discontinuation syndrome occur?
5 days
what is the most troublesome SSRI for discontinuation syndrome ?
paroxetine since it has a short half life
What symptoms does discontinuation syndrome have with SSRIs?
flu like symptoms headaches shock like sensations dizziness insomnia tears irritability
rare = movement disorders, memory, poor cognition
What symptoms does discontinuation syndrome have with MAOIs?
agitation irritable ataxia movement disorders insomnia poor cognition altered speech
What symptoms does discontinuation syndrome have with TCAs?
flu symptoms
insomnia
what is the most troublesome TCA for discontinuation syndrome ?
imipramine
what is the most troublesome MAOIs for discontinuation syndrome ?
tranylcypromine
