Benzodiazepine Withdrawal Timeline
Benzodiazepines, commonly referred to as benzos, are powerful central nervous system depressants prescribed for conditions like anxiety, insomnia, and seizures. Common benzos include alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan).
While they can be effective when used short-term, and have legitimate medical uses, benzos are also commonly used and abused in ways other than directed. Furthermore, even in those who take benzos only as medically directed, long-term use can lead to dependence and addiction.
Whether you are someone who began taking benzos as prescribed medication or began taking them illicitly, it’s important to remember that benzo dependence and addiction is treatable. But the first step in that process is to stop taking benzos and go through the detox process.
It’s important to note that benzodiazepine withdrawal symptoms don’t follow a strict schedule. The timeline and severity of withdrawal symptoms often vary based on a number of factors such as the type of benzo consumed (short-acting vs. long-acting), dosage, duration of use, and individual physiology.
That being said, the general withdrawal timeline and what can be expected can be broken down into four major phases:
Typically, symptoms begin to arise anywhere from 6 to 12 hours after the last dose of a short-acting benzo (such as Xanax or Ativan) was taken. For long-acting benzos (i.e. Valium or Klonopin), symptoms may not begin to appear for 24 to 48 hours.
When symptoms do begin to appear, they may include:
- Increased anxiety or panic
- Irritability and restlessness
- Trouble sleeping or insomnia
- Headaches
- Sweating and tremors
- Mild nausea
This phase can sometimes be referred to as the “rebound” phase, because many of the symptoms listed above are symptoms that the benzo may have been prescribed to treat in the first place.
Withdrawal symptoms typically peak during the first week, typically between the 3 and 7 day mark. Peak withdrawal is often the most intense and physically uncomfortable phase.
This phase is often marked by:
- Heightened anxiety and agitation
- Muscle pain and stiffness
- Nausea, vomiting, or diarrhea
- Heart palpitations
- Tremors or shakiness
- Hypersensitivity to light and sound
- Difficulty concentrating
- Panic attacks
In extreme cases, serious and potentially life-threatening symptoms (such as hallucinations or seizures) can occur. This is especially true for people who stopped using benzos “cold turkey” with no medical assistance.
After that first week ends, some of the more extreme and uncomfortable physical symptoms will begin to subside. However, psychological symptoms can continue for weeks.
Symptoms of this phase may include:
- Anxiety or depression
- Mood swings
- Sleep disturbances
- Brain fog and memory issues
- Intense drug cravings
- Fatigue
This is the period when relapse is most common when proper support is not in place. When physical symptoms are over, it may be more tempting to start taking benzos again to “fix” any lingering psychological issues.
While sometimes the psychological symptoms of benzo detox begin to go away after a few weeks, they can also continue to linger in some cases. This is known as post-acute withdrawal syndrome (PAWS). This condition can persist for several months or even a year after stopping benzo use, particularly for long-term users.
Common symptoms associated with PAWS include:
- Depression
- Low stress tolerance
- Cognitive difficulties
- Insomnia
- Mild but lingering anxiety
How Benzos Affect the Body
With prolonged use, the brain becomes reliant on the drug to maintain a state of calm. The body reduces its natural production of GABA, and other neurochemical systems (like glutamate, which stimulates the brain) may become overactive in compensation.
When benzodiazepines are suddenly removed, this delicate balance is thrown into chaos. Without enough GABA and with too much excitatory neurotransmitter activity, withdrawal symptoms arise. These can range from irritability and feelings of anxiety all the way up to seizures in severe cases.
Tips for Enduring Benzo Withdrawal
Benzo withdrawal symptoms are often most intense and dangerous when the person stops taking benzos suddenly in a “cold turkey” approach. This can be avoided by tapering benzo intake slowly over a period of time. By tapering, the body has time to adjust gradually, minimizing the impact of symptoms and reducing the risk of complications.
Tapering should be done under medical care and supervision, either from the person’s primary care physician or addiction treatment professionals.
Insomnia is one of the most common and frustrating withdrawal symptoms. To counter it, try the following recommendations for healthy sleep:
- Stick to a consistent sleep schedule
- Avoid screens and bright light before bed
- Practice relaxation techniques, such as deep breathing or meditation
- Avoid consuming caffeine and other stimulants in the evening
Fueling your body with healthy food supports brain recovery and overall well-being. Focus on:
- Lean proteins for support in rebuilding muscles
- Whole grains
- Leafy greens and fruits for antioxidants and vitamins
- Healthy fats (like omega-3s) for brain health
- Water for hydration
Avoid caffeine, processed sugars, and alcohol, which can worsen symptoms or increase anxiety during periods of benzo withdrawal.
While intense exercise may not be recommended (especially during early withdrawal), light activities like walking, yoga, or stretching can reduce stress, improve sleep, and stimulate endorphins.
Mental health strategies can be as vital as physical ones during withdrawal. These may include:
- Guided meditation or breathwork
- Journaling
- Cognitive behavioral therapy (CBT) techniques
- Regular therapy or counseling sessions
- Limiting exposure to high-stress situations or people
The goal is to help your brain find equilibrium again without using benzos, to create a new sense of control.
Whether it’s friends, family, or recovery groups, having people to talk to can provide emotional strength and accountability. Support groups can normalize the detox experience and offer practical tips from those who’ve walked the same path.
The Value of Medically Assisted Detox
Choosing to undergo medical detox can have many benefits, including:
Medical detox programs are staffed with doctors and other specially trained treatment and medical professionals who are available around the clock to monitor vitals, provide medications to help alleviate or treat withdrawal symptoms (when needed), and provide overall support.
Since tapering is the most effective strategy when it comes to discontinuing benzo use, medical detox programs allow for an enforceable tapering schedule. Doctors and other medical professionals can make sure the tapering is going as smoothly and comfortably as possible, adjusting the plan as needed.
Another advantage to medical detox is that medications can be administered to treat or alleviate certain withdrawal symptoms, making the detox process more comfortable.
Examples of this may include:
- Anticonvulsants to help reduce the risk of seizures
- Beta blockers to help with heart palpitations or tremors
- Non-benzodiazepine sleep aids to help with insomnia
While some people may be apprehensive about taking more medications, it’s important to note that all medications administered during detox are not only FDA-approved but also carefully selected to avoid further dependence.
As we have touched on, benzo withdrawal is just as much of a psychological process as it is a physical one. Medical detox programs provide access to mental health professionals, group therapy, and crisis intervention when needed.
While detox is an important step in the recovery process, it is only the first step. At Cypress Lake Recovery, our medical detox program is on the same campus as our residential treatment program. Once your detox has been completed, you can begin treatment without having to pack up and go to another facility.
Receive Help for Benzodiazepine Addiction and Learn More at Cypress Lake Recovery
Our multidisciplinary team provides medically supervised detox, personalized tapering plans, and therapeutic support in a compassionate, nonjudgmental environment. Whether you’ve been using benzos for months or years, our experts are here to walk beside you every step of the way.
Don’t try to face benzo withdrawal alone. Contact us today to speak with an admissions specialist and learn more about your options for safe detox, compassionate support, and lasting recovery.
