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Benzodiazepine withdrawal can be a long and difficult process, but there are steps that physicians can take to help their patients survive the process. Tapering the drug slowly and switching to a long half-life benzodiazepine may be helpful, as may adjunctive medications and coping skills. Encouraging acceptance and finding a support system can also be key to surviving benzodiazepine withdrawal. Addition of an anticonvulsant (e.g., gabapentin [Neurontin]) should be considered for high-dosage withdrawal. There are three basic approaches to a benzo-diazepine taper: (1) use the same medication the patient tolerates withdrawal symptoms during the taper. Addition of an anticonvul-sant (e.g I was put on Gabapentin during benzo withdrawal and then CTd off at 300mg in a psych ward after getting akathisia. I am sure the Gabapentin played a role in that. I would not take it if someone offered me a million dollars knowing what I know now. Psychiatrists and addiction specialists are, counterintuitively, often not educated about benzo harm, slow cessation, severe withdrawal effects, benzodiazepine withdrawal syndrome, microtapering or protracted withdrawal risks. These specialties tend to misdiagnose withdrawal symptoms as new mental illness and prescribe more psychotropics. Gabapentin will mask benzo withdrawal symptoms. That may seem like a good thing, but when you finally reduce/eliminate the gabapentin, the benzo withdrawal symptoms may still be there. And/or gabapentin withdrawal may occur. UpToDate Researchers found a total daily dose of 600 mg to 1,800 mg of gabapentin reduced withdrawal symptoms. Additionally, they reported no complications with the combination of gabapentin The Ashton Manual outlines a specific tapering schedule for gabapentin that is designed to minimize withdrawal symptoms and ensure a successful taper. The schedule involves gradually reducing the dosage of gabapentin over a period of several weeks or months, depending on individual needs. Depending on the patient and the benzodiazepines involved, substitution can add 1-4 weeks to a taper. Some patients may find substitution intolerable, whether due to the differing phramacokinetics or the equivalency ambiguities of the two benzodiazepines. al is necessary. Gabapentin, an anxiolytic drug that is also used off-label to treat alcohol withdrawal, is a potential candidate for modulating benzodiazepine withdrawal. Using electronic records from a large inpatient psychiatric facility, a retrospective study of 172 patients presenting with benzodiazepine withdrawal was conducted to determine if the coincidental use of gabapentin for other Gabapentin 300 mg HS the day before stopping the final 10-20% of benzodiazepine dose. Did patient have an anxiety disorder before initiation of benzodiazepine(s)? Initiate benzo taper using 16 week taper plan. Recommend monthly assessment OV. Developed by a multidisciplinary group led by ASAM, this guideline aims to assist clinicians in helping patients safely taper from their benzodiazepine medication, while minimizing withdrawal symptoms. Conclusions: Our findings demonstrate that using gabapentin with benzodiazepine was associated with a reduction in the cumulative benzodiazepine dosage for alcohol withdrawal. Considering gabapentin as an adjunctive therapy holds promise for patients with comorbidities who could benefit from reducing benzodiazepine dose. This strategy warrants I used gabapentin to get off benzos. I was on them for maybe month and a half. I never really noticed them doing much and I was on a super high dose (2400mg I think). According to Tran et al. (2005) in their study “Gabapentin Withdrawal Syndrome in the Presence of a Taper,” withdrawal symptoms still occur even with a gradual taper, particularly in patients who have been on high doses for extended periods. The study reported a case where a 76-year-old woman experienced anxiety, tremors, and nausea during Prescribing information and the American Addiction Centers recommend tapering gabapentin over a minimum of one week. Using a slow taper by reducing the daily dose at a rate of 300 mg every 4 days may be particularly useful for elderly patients or other patients vulnerable to withdrawal symptoms. See tables 1 through 5 for case reports describing gabapentin tapers. It may take months to years to fully taper off BZDs, particularly if patients have been taking a high dose for an extended period of time. Give the brain time to adjust. Adjunctive medications can be considered but generally try to avoid other GABAergic medications (eg, gabapentin, Z-drugs) some withdrawal symptoms and prevent withdrawal complications. Benzodiazepines are frequently utilized in a tapering fashion for medical withdrawal from alcohol or benzodiazepine dependence. It is likely that individuals will have difficulty being admitted to a facility that I personally felt Gabapentin saved my life and allowed me to get off Benzos. It acts on the same receptors but isn’t going to hit as hard as a benzo. Most people I was in treatment with took Gabapentin to ease withdrawal symptoms.
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