Acute w d sx may occur w in 1 7 days can last 4 14 days after BZD d c sx generally more severe but shorter in duration w BZD w short vs long half life1 2

By rray, 26 September, 2023
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<sup>1</sup> <b>VA 2021.</b> Re-evaluating the Use of Benzodiazepines. A Quick Reference Guide. U.S. Department of Veterans Affairs. October 2021. <a href=https://www.pbm.va.gov/PBM/AcademicDetailingService/Documents/508/10-1527_BENZOS_QRG_508conformant.pdf><u>Free full-text PDF</u></a>
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<sup>2</sup> <b>VA/DoD 2021.</b> VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders. (Based on evidence reviewed through June 30, 2020.) Version 4.0. U.S. Department of Veterans Affairs. U.S. Department of Defense. August 2021. <a href=https://www.healthquality.va.gov/guidelines/MH/sud/VADoDSUDCPG.pdf><u>Free full-text PDF</u></a>
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<sup>3</sup> Ashton CH. Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual). benzo.org.uk. Updated August 2002. <a href=https://www.benzo.org.uk/manual/index.htm><u>Accessed September 15, 2023</u></a>
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• An estimated 10% to 15% of long-term BZD users will develop protracted w/d sx (i.e., post-acute w/d syndrome)
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Mild anxiety insomnia
Moderate diaphoresis HA irritability muscle pain stiffness N V palpitations panic attacks poor concentration sleep disturbance tremor wt loss
Severe sz psychosis
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Acute w/d sx may occur w/in 1-7 days, can last 4-14 days after BZD d/c; sx generally more severe but shorter in duration w/ BZD w/ short vs. long half-life<sup>1,2</sup>