Benzodiazepine-induced neurological dysfunction (BIND) can come with a barrage of expected, unexpected, and even sometimes bizarre physical and psychological symptoms. Neuroadaptation and neurotoxicity has caused the central nervous system to become hypersensitive and over-reactive to everyday stimuli, leaving these symptoms in its wake.
The following is a list of possible side effects reported by individuals who have experienced difficulties during benzodiazepine withdrawal. We have categorized these symptoms into 14 categories. Seven are psychological symptoms including anxiety symptoms, behavioral symptoms, cognitive symptoms, excitability symptoms, perception symptoms, sleeping symptoms, and social symptoms. And the other seven are physical symptoms including abdominal/gastrointestinal symptoms, symptoms of the eyes, ears, nose & mouth, symptoms of the head & neck, symptoms of the heart & lungs, muscular symptoms, nerve sensations, and immune & endocrine symptoms.
We did a 14-part series on the Benzo Withdrawal focused on the various categories of withdrawal symptoms. Here is the introduction below. The remainder of the episodes can be found in their respective symptom categories following.
Benzo Free Podcast: Episode 8 An Introduction to Benzo Withdrawal Symptoms
This list is a general resource. Just like the list of possible side effects on a medication label, nobody will get all, or even most, of the symptoms listed. In fact, many discontinue benzodiazepines with little or no difficulty at all. For those who do have symptoms, it can be helpful to know that they might be caused by benzos, and that they will fade over time. If you are easily triggered by this type of content, you might want to refrain from reading.
Generalized Anxiety – People with Generalized Anxiety Disorder (GAD) often experience chronic, consistent worry about a variety of issues and concerns. This is the most common form of anxiety.
Hypochondria – Hypochondria is also known as hypochondriasis, illness anxiety disorder, or somatic symptoms disorder and it’s often identified by constant worrying about one’s own health. This is perhaps the most frightening type of anxiety during BIND due to the continuous barrage of physical aches, pains, sensations, and perceptions that give an obsessive mind plenty of ammunition.
Panic Attacks – Prof. Ashton states: “Panic attacks may appear for the first time during withdrawal, although some patients have long experience with this distressing symptom.” Ashton also reminds patients that these rarely last longer than half-an-hour and are never fatal.[Ashton, The Ashton Manual.]
Paranoid Thoughts – Normal anxious thoughts are often confused as paranoia. Clinical paranoia is identified as experiencing consistent, ongoing suspicions that are unfair and unrealistic. Paranoid thoughts, like jealousy, conspiracy theories, and the feeling that others are out to get you, can be elevated during withdrawal.
Phobias – The list of identified and named phobias numbers in the hundreds. Many are familiar with the more common ones, such as acrophobia, agoraphobia, and claustrophobia. In benzo withdrawal, preexisting phobias can escalate, and new phobias can emerge.
Benzo Free Podcast: Episode 9 Anxiety: The Beast of Benzo Withdrawal
Anger/Irritability/Aggression – During sustained benzodiazepine use, our calming mechanism can become damaged, which can make it more difficult for us to control our feelings of anger, aggression, and rage. This experience is sometimes referred to as “benzo rage.” This lack of control can lead to physical violence and abuse.
Depression/Suicidal Thoughts – Depression is quite common during withdrawal and BIND. While it may not be a direct effect of the benzos, the suffering many endure could in of itself cause the onset of moderate to severe depressive episodes. Depression can lead to suicidal thoughts during withdrawal, and these thoughts need to be taken seriously and managed with therapy, medication, and support, as needed. If you are having suicidal thoughts, please seek help.
Obsessions – Obsessive traits, such as OCD, may be increased during withdrawal. It’s important to remember the cause of this increase and know that they will usually decrease as we start to heal.
Benzo Free Podcast: Episode 13 Benzo Bad Guys: Anger, Aggression, Depression and Obsession
Benzo Free Podcast: Episode 67 Anger and Irritability in Benzo Withdrawal
Cognitive/Memory Dysfunction – Poor memory and cognitive dysfunction are two common and very distressing side effects of BIND. Unfortunately, these can be some of the last symptoms to fully recover.
Intrusive Memories – Another very uncomfortable cognitive side effect can be intrusive memories. These can be traumatic events from someone’s past or even a vivid memory of another person they haven’t seen or thought about for years. One theory is that this is linked to dreaming. Since benzos affect REM and SWS sleep and often prevent dreaming during their use, this could be a sign of healing, and that normal dreaming is starting to return.
Benzo Free Podcast: Episode 17 Benzo Brain: Cognitive Dysfunction and Memory Loss in Withdrawal
Benzo Free Podcast: Episode 73 Benzo Brain: Cognitive Symptoms in Withdrawal
Akathisia – Simply put, akathisia is a disorder where the patient has a feeling of inner restlessness and the urgency to keep moving. It’s like being on high doses of caffeine all the time, even when you’re trying to sleep.
Jumpiness – Jumpiness, or reactive movements, are also common in withdrawal and BIND. The patient’s body is very sensitive to a variety of stimuli, thus the body has a tendency to over-respond.
Restless Legs – Restless leg symptoms are also common and often happen in tandem with akathisia.
Benzo Free Podcast: Episode 23 Perpetual Motion Madness: Excitability Symptoms of Benzo Withdrawal
Depersonalization/Derealization – Both of these disorders are related to feeling detached from reality. Depersonalization is feeling detached from yourself as if you’re viewing yourself from outside your body. Derealization is feeling disconnected from your surroundings, almost like you’re living in a dreamlike state. Vertigo and lightheadedness are also common with derealization. Some experts believe that it’s a defense mechanism that helps the body cope with excessive suffering by detaching from the experience.
Hallucinations – Hallucinations are perhaps the most terrifying of all possible symptoms. They’re more common in acute withdrawal and are rare in BIND. Treatment usually involves helping the patient recognize that the hallucination is unreal, which aids in alleviating the fear.
Misperceptions / Perceptual Distortions – Incorrect understanding or abnormal interpretations of experiences can be a symptoms of BIND in some people.
Benzo Free Podcast: Episode 28 The Loss of Reality: Perception Symptoms of Benzo Withdrawal
Insomnia – Insomnia is one of the most common complaints during BIND. Since benzos are frequently used as a treatment for insomnia, it makes sense that withdrawal from the drug could affect a person’s ability to sleep. The sleep that people experience while taking benzos is not a typical, healthy type of sleep. Benzos inhibit both REM (rapid eye movement) sleep and SWS (slow wave sleep), so the patient doesn’t get the deep sleep that his/her body really needs.
Nightmares – During tapering, withdrawal. and BIND, many patients experience very vivid dreams and nightmares. This may be a sign of recovery. The dream process was subdued during benzo use and now is starting to return to its normal functioning. The nightmares usually subside in a couple of months once the body adjusts to normal REM sleep.[Ashton, The Ashton Manual.]
Benzo Free Podcast: Episode 32 The Restless Pursuit of Rest: Insomnia in Benzo Withdrawal
General Social Anxiety – General social anxiety is a widespread problem for people on benzos. Many started taking the drug because of this issue, and others developed it during the process. It can be very frightening and extremely limiting.
Specific Social Anxiety – Some also develop social anxiety only in specific environments or situations.
Benzo Free Podcast: Episode 36 Interminable Isolation: Social Symptoms in Benzo Withdrawal
Benzo Free Podcast: Episode 64 Surviving Isolation: Benzo Withdrawal in Chaotic Times
Abdominal / Gastrointestinal Symptoms
Abdominal Pain – Pain in the abdominal area is quite common during withdrawal. The cause is not always known, but most of the time it appears to be related to the gastrointestinal tract. It can range from a mild nuisance to severe pain and seems to be influenced by diet, anxiety, and the randomness of BIND’s waves and windows.
Appetite/Weight Change – Ashton has stated that considerable weight loss (8–10 lbs. or more) can occur during BIND.[Ashton, The Ashton Manual] Since benzos can increase appetite, this might be a rebound effect. Gastric distress might also be a cause since many people are forced to adapt their diet to manage symptoms.
Constipation – Constipation can occur during BIND and is often aggravated by over-breathing. Natural laxatives can help with this condition.
Distension/Inflammation – One of the most surprising and frightening symptoms of BIND can be abdominal distension. Both men and women have experienced significant and sometimes painful distension, to the point of appearing to be in a late-stage of pregnancy. This is usually experienced in conjunction with digestive difficulties, which causes inflammation. It’s not a permanent condition, and changes in diet can help manage it.
Gastritis/Diarrhea/Nausea/Vomiting – Due to the effect that BIND has on the overall digestive system, other symptoms, such as diarrhea, nausea, and vomiting may not be a surprise. Symptoms common with irritable bowel syndrome, gastritis, acid reflux, and other digestive difficulties are also quite prevalent.
Groin Pain – The upper abdomen is not the only location to experience pain during BIND. The groin area can be affected too. Inflammation of the gut can affect the lower abdomen and groin. Factors that also come into play include chronic muscle tightness and injury.
Menstrual Difficulties – Benzos and BIND can play havoc with a woman’s menstrual cycle, including heavier bleeding, irregular periods, cessation of periods, bleeding between cycles, and increased breast pain. Women do need to be cautious of anemia and other complications during this time if their cycles become too frequent.
Pelvic Floor Dysfunction – Pelvic floor dysfunction has been a common diagnosis in women for some time and is rapidly becoming more common in men as well. It can be aggravated by, or even first appear, during BIND. Due to effects that the removal of benzodiazepines have on the tightness of our muscles and on inflammation in the abdomen, this is not unforeseen.
Urinary Difficulties – Increased urinary frequency can be common with BIND. Urgency, leaking, and even inability to urinate are also prevalent.
Benzo Free Podcast: Episode 11
Benzo Free Podcast: Episode 49 The Pelvic Problem: Benzo Symptoms of the Pelvis and Lower Abdomen
Benzo Free Podcast: Episode 60 Benzo Belly: Our Gut in Withdrawal (Take 2)
Symptoms of the Eyes, Ears, Nose & Mouth
Blurred/Double Vision – Some people suffer from vision problems during BIND. Discontinuation can affect the eye muscles, which can lead to distorted vision or even eyelid spasms.
Difficulty Swallowing – This can be quite distressing and may even feel like a choking sensation at times. The best course of action is to eat slowly, take small bites, and chew your food thoroughly.
Dry Mouth/Metallic Taste – People can experience dry mouth during BIND. It’s usually a mild issue but can lead to other problems of the mouth. A metallic taste is also typical.
Oral Thrush – Oral thrush (Oropharyngeal Candidiasis) happens when candida yeast spreads into the mouth. It can appear as white spots inside the mouth, but often the area infected just becomes red and sore. Avoiding foods with gluten, sugar, and some dairy products can help. If this issue is severe, a doctor can prescribe an antifungal medication.
Sore/Dry Eyes – Some people complain of dry eyes during BIND, often in conjunction with dry sinus and mucous membranes.
Sound & Light Sensitivity – It’s not uncommon for people in BIND to say they have an extreme sensitivity to sounds and light. Their nervous systems have become hyper-excited and can overreact to regular everyday stimulation. Some people have been forced to isolate themselves in their homes to avoid this sensation.
Tinnitus – Tinnitus is very common in BIND. Constant or periodic ringing or noise in the ears can range from a mild annoyance to very distressing. There are other possible causes of tinnitus, so if it’s severe, it may be wise to visit a specialist to get checked out.
Unusual Smell – The olfactory senses can also be affected by BIND. Some people speak of a burned smell. Most of the time there are no external causes for these sensations. Some people even have smells return with the reconnection to lost memories.
Benzo Free Podcast: Episode 16
Symptoms of the Head & Neck
Balance Issues – The cerebellum, which controls your motor stability and maintains equilibrium, is full of GABA receptors and is heavily affected by benzos. When damaged, it can affect one’s ability to maintain balance. This is often the cause of falls in the elderly.
Dizziness/Lightheadedness/Vertigo – Along with anticholinergics and antihistamines, benzodiazepines are commonly used as vestibular suppressants and are often taken by people who suffer from motion sickness, motion sensitivity, and vertigo. When the drugs are removed, the vestibular system reacts and can cause dizziness and lightheadedness during recovery.
Headaches / Migraines – Headaches are another common complaint during BIND and are often combined with pressure in the forehead and temples. Some complain that it feels like there is a tight band around their head. Migraines can also be triggered during this time.
Neck Pain – Neck pain often occurs in conjunction with headaches and sometimes chest pain. This is most likely due to muscle tightness in the area, which is aggravated by stress and the reduction of the benzodiazepines — benzos are excellent muscle relaxants.
Slurred Speech – Dysarthria is the medical term for difficulty speaking, which is indicated by slow or slurred speech. It’s often a result of neurological injury, which can include benzodiazepine dependence, withdrawal, and BIND. This can be exacerbated by alcohol and lack of sleep.
Throat Tightening – In addition to difficulty swallowing, some people also feel like their throat is tightening or swollen. This is a common symptom of excessive anxiety, so it’s no surprise that it also appears during BIND. Relaxation exercises can help ease the tension in the neck.
Benzo Free Podcast: Episode 20 Unsteady, Unintelligible, and Unyielding: Head and Neck Symptoms of Benzo Withdrawal
Symptoms of the Heart & Lungs
Breathing Difficulties – Breathing difficulties are common including hyperventilation (over-breathing) and hypoventilation (depressed breathing). Benzos can suppress respiration and have a track record of affecting breathing patterns. When mixed with opiates, they can cease breathing altogether causing death. If you feel you have significant breathing issues during withdrawal, please speak with your doctor immediately.
Flushing/Sweating/Skin Conditions – Flushing, excessive sweating, burning of the skin, heat rashes, and related skin conditions are part of the benzodiazepine hall-of-crazy-symptoms. They can be quite irritating and occasionally painful, but they’re rarely dangerous.
Heart Palpitations – Heart palpitations are another one of the scary symptoms that often send people to the emergency room. These are also common in panic attacks and heightened states of anxiety but are usually benign. Beta blockers help some people during withdrawal if the palpitations are severe. Consult with your doctor if you feel these are needed.
Benzo Free Podcast: Episode 24 Cardiopulmonary Consternation: Heart and Lung Symptoms of Benzo Withdrawal
Possible muscular symptoms can include aches, convulsions, fatigue, jerks, pains, pulls, spasms, sprains, stiffness, tears, tics, tremors, twitches, and overall weakness.
Benzos are very effective muscle relaxants. By the time the drugs are removed from one’s system the muscles have been chemically relaxed for months or even years, and now they need to figure out how to behave in this new drug-free environment. The removal of a long-term muscle relaxant, in addition to damage to the nerves that signal the muscles, can create a painful cascade effect with some bizarre results.
While limited exercise is generally beneficial during BIND, caution needs to be maintained to avoid injury.
Benzo Free Podcast: Episode 29 Tight, Tense, and Twitching: Muscular Symptoms in Benzo Withdrawal
In addition to akathisia, burning sensation of the skin, muscle tics, tremors, and spasms as defined in previous categories, nerve sensations can also include the following:
Paresthesia – Paresthesia refers to strange sensations on or near the surface of the skin with no apparent physical cause. Common complaints include burning, tingling, pins and needles, numbness, or even electrical impulses.
Formication – Formication is a unique type of paresthesia usually identified by the feeling of something crawling on the skin, like a spider or bug.
Benzo Free Podcast: Episode 33 Sights, Sounds, and Sensitivities: Nerve Sensations of Benzo Withdrawal
Immune & Endocrine Symptoms
Immune System – Some people seem to get more infections during BIND. Since most are under more stress during withdrawal, and knowing that chronic stress can lower the immune system’s ability to fight off germs, this makes sense. Depression also can be a cause of diminished immunity. Another factor is that people going through BIND tend to live a less healthy lifestyle.
Endocrine System – As for the endocrine system, we know that benzos have an effect, but there is little information on this topic from related studies. Some women complain about menstrual difficulties, but these are common in the general population too, so it’s hard to determine a cause and effect. Both male and female patients have occasionally complained about breast swelling and engorgement during withdrawal. The good news is that most endocrine system issues do improve once withdrawal is complete.
Benzo Free Podcast: Episode 43 Immune and Endocrine Symptoms of Benzo Withdrawal
Ashton, C. Heather. Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual). 2002. Accessed April 13, 2016. http://www.benzo.org.uk/manual/.
“Benzodiazepine Withdrawal Symptoms.” BenzoBuddies. Accessed April 23, 2017. http://www.benzobuddies.org/benzodiazepine-information/withdrawal-symptoms.
Foster, D E. Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, Colorado: Denim Mountain Press, 2018. https://easinganxiety.com/book.
For Information Purposes Only – Not Medical Advice
All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician.
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