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Benzodiazepine Withdrawal Psychosis: Symptoms & Timeline

“Benzos” or benzodiazepines are potent and addictive sedative drugs that are prescribed to treat anxiety, insomnia, and seizures.

As sedatives or central nervous system depressants, benzos are designed to reduce nerve activity in the brain and spinal cord, producing a calm and relaxed sensation. Although these drugs are meant to be taken as prescribed by a doctor, many people abuse benzos for the sedative high they produce when taken in high doses. However, when it comes to quitting or reducing their intake, many who are addicted to these drugs experience benzodiazepine withdrawal psychosis and all of the adverse side effects that come with it.

 

What Is Psychosis?

Psychosis is an umbrella term used to describe conditions that affect your mind and disconnect you from reality. When a person experiences psychosis or moments of psychosis, these are referred to as psychotic episodes.

Psychosis affects the way your mind processes information. It causes you to lose touch with or disconnect from reality. During a period of psychosis, you may experience disturbing thoughts or perceptions and also have trouble understanding the situation and what’s going on around you.

Common symptoms of psychosis include delusions (false beliefs) and hallucinations (seeing or hearing things that aren’t real). Other symptoms may include incoherent speech or speech that doesn’t make any sense to others and behavior that’s inappropriate for the current situation.

Psychosis is not a condition itself but rather a symptom of other conditions. You may have heard of this word being used in conversations about mental disorders like schizophrenia and bipolar disorder, but it’s also a common condition among drug users.

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Benzodiazepine-Induced Psychosis

While specific mechanisms of action vary from drug to drug, most substances with a potential for abuse and addiction can significantly alter brain function in ways that disrupt perception and cognition. Benzodiazepines are among the many drugs that cause a disturbance in cognition, altering the person’s mental state, slowing their response time, distorting their normal thought processes, and even affecting their memory.

If you’ve ever wondered, “can benzodiazepines cause hallucinations” the answer is yes. Physicians often refer to the sudden onset of symptoms like hallucinations and delusions as “delirium” instead of “psychosis.” “Delirium” refers to a short period of drug-induced delusions and hallucinations, while “psychosis” refers more commonly to a symptom of a mental disorder.

Benzo-induced psychosis can occur when a person takes a large dose of benzos or mixes them with other drugs or alcohol, causing intoxication. However, it’s most common among people who are withdrawing from these drugs.

Benzos work by enhancing the effects of a chemical called gamma-aminobutyric acid (GABA), which is also referred to as an inhibitory neurotransmitter because it blocks messaging between nerve cells to reduce activity in the central nervous system. As a result, a person who takes benzos may experience a sense of relaxation and calm.

However, in large doses and when mixed with other drugs or alcohol, benzodiazepines can affect people so strongly that their thinking slows, their judgment is impaired, and they can rarely understand what’s happening. As intoxication kicks in, delirium progresses into benzodiazepine psychosis, including symptoms like visual distortions, hallucinations, confused thoughts, and paranoia.

 

What Is Benzodiazepine Withdrawal Psychosis?

Also referred to as Klonopin withdrawal psychosis, Ativan-induced psychosis, and benzodiazepine-induced psychosis, benzodiazepine withdrawal psychosis or delirium may occur when the use of these drugs is suddenly stopped or reduced.

Stopping benzos without medically monitored detox can be highly dangerous, especially when the person has been abusing them for long periods. Benzodiazepine withdrawal symptoms may include a variety of physical complications, such as high blood pressure, heart palpitations, insomnia, and even seizures.

Additionally, people with existing mental disorders or conditions like insomnia are more likely to experience delirium and other side effects when withdrawing from benzos. Certain benzos are also more likely to produce psychotic symptoms

People who take Xanax, for instance, are at an increased risk of severe withdrawal symptoms, including psychosis. The drug’s short half-life compared to other benzos causes more sudden and intense withdrawal symptoms, making it more difficult for the brain to adjust to the change.

Even people who don’t experience any medical complications from benzo withdrawal may experience benzodiazepine withdrawal psychosis. It’s possible to experience psychosis solely from benzo withdrawal. Research also suggests that normal administrations of benzos can also produce psychosis.1

While the specific causes are unknown, some neuroscientists believe that people who abuse or use benzos long-term become accustomed to them and that previously depressed neurons begin firing rapidly once use is stopped. Basically, their brains are so accustomed to a daily “chill pill” that the day it doesn’t receive this medication, it reacts as it did before.

This excited state that the brain jumps into during benzo withdrawal is the opposite of the drug’s side effects, mimicking a state of intoxication. Simply put, benzo withdrawal psychosis is caused by a sudden increase in the neural activity in the brain when the use of the drug is stopped, which can lead to certain symptoms.

 

Symptoms

Symptoms of benzo withdrawal psychosis are often different from those of other psychotic disorders, like schizophrenia. These include auditory hallucinations and paranoid delusions.

Although people with benzo withdrawal psychosis may experience similar symptoms, they tend to develop symptoms that are uncommon to schizophrenic patients – such as visual hallucinations – and also tend to develop more rapidly than symptoms of other psychotic disorders.

ommon symptoms of benzodiazepine withdrawal psychosis include:

  • Hearing, seeing, or tasting things that other people don’t
  • Having unusual beliefs or thoughts, no matter what others say or what evidence is presented
  • Reduced hygiene
  • Isolation from friends and family
  • Difficulty thinking clearly or paying attention
  • Auditory hallucinations (hearing voices that aren’t real)
  • Visual hallucinations (seeing people or things that aren’t real or seeing distorted shapes)
  • Delusions or beliefs that don’t align with your culture or don’t make sense to others
  • Feeling as if outside forces are controlling your feelings and behavior (delusion)
  • Giving significant meaning to small events or comments (delusion)
  • Feeling as if you have superpowers or are on a special mission (delusion)

Benzo withdrawal hallucinations and delusions can be terrifying and disturbing. The physical symptoms of detoxing from benzos can also be uncomfortable and even dangerous without medical assistance

It’s important to utilize the help of a benzo addiction treatment and detox to safely overcome withdrawal symptoms and achieve recovery. At our Banyan rehab in Boca Raton, we not only offer treatment and detox, but we also provide dual diagnosis treatment to those who suffer from both a mental disorder and addiction and need individualized care that addresses both.

 

Duration

Benzo withdrawal symptoms come and go and usually dissipate after a few days. Most benzo withdrawal symptoms begin within 24 hours after the person’s stopped or reduced their use and can last for several days to several months.

Prolonged withdrawal isn’t uncommon, and many people who abuse benzos may continue to experience withdrawal symptoms even years after they've stopped taking them.

When it comes to benzo withdrawal delirium or psychosis, symptoms usually come in stages. First, the person may experience a rebound of anxiety and insomnia within the first one to four days of withdrawal. Then, the psychosis or state of delirium itself may last from 10 to 14 days. Finally, the person may experience another stage of anxiety, which may persist until treatment is received.2

 

Benzo Withdrawal Treatment

It’s important for people who wish to discontinue their use of benzos to be aware of the potential withdrawal symptoms that can occur. Our rehab in Boca Raton, Florida, usually recommends benzodiazepine withdrawal treatment to patients to minimize their risk of psychosis and other discomforts.

If you have been using benzos and believe that your use has progressed to addiction, Banyan Treatment Centers Boca offers a variety of treatment options that can help. Whether you need addiction treatment, inpatient mental health treatment, or both, our team works together to create a plan that works for you.

Ready to start? Call Banyan Boca today at 888-280-4763 to learn more about psychosis and how we can help you recover from addiction.

 

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Alyssa, Director of Digital Marketing
Alyssa, Director of Digital Marketing
Alyssa is the National Director of Digital Marketing and is responsible for a multitude of integrated campaigns and events in the behavioral health and addictions field. All articles have been written by Alyssa and medically reviewed by our Chief Medical Officer, Dr. Darrin Mangiacarne.