Preventing Medication Withdrawal

A: The most common effects are:

• Sleepiness and overall fatigue
• Extreme Nausea/Flu-like symptoms
• Dizziness
• Difficulty driving/concentrating
• Confusion/Fuzzy thinking
• Rapid heart beat
• Agitation/Anxiety
• Seizures
• Inability to move/ ongoing rigid state for several days or weeks (catatonia)
• Intestinal bleeding

A: Some people develop withdrawal symptoms after stopping the medication for a few days while others have no withdrawal symptoms even after taking medication for several weeks.

A: Talk to your healthcare provider FIRST! The best way to lower or stop anticonvulsant use is by slowly cutting back on the daily dose of medication over time (taper) under medical supervision. If you recently stopped taking anticonvulsants and are experiencing any withdrawal symptoms, seek medical attention.

A: Watch for:

• anxiety
• fatigue
• nightmares
• trouble sleeping
• depression and mood swings
• loss of coordination
• muscle spasms
• dizziness
• difficulty balancing
• nausea
• vomiting
• flu-like symptoms
• headache

A: This depends on how soon the medication leaves the body. Shorter acting preparations cause more troublesome symptoms than longer acting:

A: Talk to your healthcare provider FIRST! The best way to lower or stop antidepressant use is by slowly cutting back on the daily dose of medication over time (taper) under medical supervision. If you recently stopped taking antidepressants and are experiencing any withdrawal symptoms, seek medical attention.

A: The most commonly prescribed benzodiazepines include:

• chlordiazepoxide (Librium)
• diazepam (Valium)
• clonazepam (Klonopin)
• flurazepam (Dalmane)
• alprazolam (Xanax)
• loprazolam (Ativan)
• midazolam (Versed)
• oxazepam (Serax)
• temazepam (Restoril)

A: Withdrawal symptoms from benzodiazepines can occur when:

• the medication is rapidly reduced or abruptly discontinued, or
• another medication is given to reverse the effect of the benzodiazepine, like flumazenil (Romazicon)

Benzodiazepine withdrawal can be severe and life-threatening, especially when the amount is suddenly lowered from high doses or for long-time users.

A: They can cause the following symptoms:

• Sweating
• Increased tension and anxiety
• Restlessness and irritability
• Panic attacks
• Severe insomnia (inability to sleep)
• Tremors, numbness, tingling
• Nausea/vomiting/dry retching
• Difficulty concentrating/memory problems
• Confusion and difficulty thinking/understanding
• Muscle aches and stiffness
• Heart palpitations/chest pain
• High blood pressure/elevated body temperature
• Headache
• Hallucinations
• Seizures/coma
• Paranoia, psychosis, mania
• Suicidal thoughts or actions
• Violence

A: This depends on whether the drug is short-acting or long-acting:

A: Talk to your healthcare provider FIRST! The best way to lower or stop antidepressant use is by slowly cutting back on the daily dose of medication over time (taper) under medical supervision.

If you recently stopped taking benzodiazepines and are experiencing any withdrawal symptoms, seek medical attention IMMEDIATELY:  call 911 or go to the nearest emergency room or urgent care center.

A: Opioids include morphine, oxycodone, oxymorphone, hydrocodone, hydromorphone, methadone, codeine and fentanyl.

A: Opioids (or opiates) are the class of medications derived directly from opium found naturally from the poppy seed (like morphine, heroin) or from synthetic or semisynthetic morphine-like substances (like fentanyl). All opioids except for heroin are legal yet controlled by the U.S. federal government. They are expected to be prescribed for legitimate medical need only.

Narcotic is the legal “catch-all” term for both legal and illegal drugs; according to the DEA fact sheet:  “narcotic” comes from the Greek word for “stupor” and originally referred to a variety of substances that dulled the senses and relieved pain. It is not uncommon for other illegal drugs, such as cocaine, PCP and heroin to be included in this term.

A: Withdrawal symptoms from opioids can occur when:

• the medication is abruptly discontinued or rapidly reduced, or
• another medication is given to reverse the effect of the opioid (called an antagonist, like Narcan).

A: They are:

• Sweating
• Anxiety
• Restlessness
• Insomnia (Inability to sleep)
• Dilated pupils
• Nausea/vomiting
• Diarrhea
• Abdominal Cramping (pain)
• Muscle aches
• Chills (goose bumps)
• Excessive tearing of the eyes
• Runny nose

A: This depends on whether the drug is short-acting or long-acting:

A: Talk to your healthcare provider FIRST! The best way to lower or stop opioid use is by slowly cutting back on the daily dose of medication over time (taper).  Opioid taper, particularly for those who have been on long term therapy, should be performed under medical supervision. Underlying medical conditions, like high blood pressure, heart disease and other chronic diseases could become unstable during unplanned or unmonitored withdrawal.

A. Stimulants include:

• methylphenidate (Ritalin, Concerta, Metadate CD)
• dexmethylphenidate (Focalin, Attenade)
• dextroamphetamine (Dexedrine)
• amphetamine (Benzedrine)
• dextroamphetamine mixed salts (Adderall)
• methylphenidate transdermal patch (Daytrana)
• Illegal substances such as cocaine and crack are also stimulants.

A: Withdrawal symptoms can happen when the:

• Stimulant is abruptly discontinued or rapidly reduced (or)
• Another medication is given to reverse the effect of the stimulant effect (like a sedative).

A: They can vary, such as:

After a 2-3 day binge:

• Feelings of helplessness, guilt, anxiety, depression
• Exhaustion
• Sleepy; drowsy for 24 to 48 hours.

After long term, high dose use:

• Irritability/anxiety
• Difficulty sleeping (insomnia)
• Intense dreaming
• Lack of interest/indifference
• Increased appetite/cravings
• Long periods of sleep
• Disorientation
• Hallucinations
• Seizures
• Psychosis
• Stroke
• Heart attack
• Death

A: This depends on whether the drug is short-acting or long-acting. For short acting preparations, this can occur within 24 hours of the last dose:

A: Talk to your healthcare provider FIRST! The best way to lower or stop stimulant use is by slowly cutting back on the daily dose of medication over time (taper).  Stimulant taper, particularly for those who have been on long term therapy, should be performed under medical supervision.