Because of these concerns, it may not be in the best interest of patients who have both panic disorder and a current substance abuse problem to use the BZs for their anxiety. Studies indicate that between 35 and 45 percent of patients are able to withdraw from the BZs without difficulty. These are symptoms of withdrawal, rebound, and relapse, which can sometimes occur simultaneously. Physical dependence means that when a person stops taking a drug or reduces the dose quickly, he or she will experience symptoms of withdrawal.Benzodiazepines should never be taking while attempting to become pregnant, while pregnant or while breastfeeding. BZ withdrawal symptoms usually begin soon after reduction of the drug begins.If taken after meals, side effects such as drowsiness can diminish, and the therapeutic effects can last longer.Your physician can increase this dosage by adding 0.5 mg to one of the three daily doses up to a maximum of 2 mg three times per day.Between 10 to 35 percent of patients will experience the rebound of anxiety symptoms, especially panic attacks, when they discontinue the BZs too rapidly. One approach is to remain at each new lower dose for two weeks before the next reduction. About 10 to 20% of panic disorder patients fail to respond adequately to Xanax.Tapering a BZ over a two- to four-month period can lead to significantly less withdrawal symptoms. Helpful for phobias, social anxiety, OCD, and panic disorder. To block panic attacks, two to four weeks of treatment may be needed. Do not take if planning to get pregnant, while pregnant or while breast-feeding.
Studies suggest that they are effective in reducing symptoms of anxiety in approximately 70-80% of patients. Tolerance does not develop in the anti-panic or other therapeutic effects.
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Z-drugs are non-benzodiazepine drugs that are often used to treat insomnia and other sleep disorders.
Rarely, a patient will experience disinhibition: they lose control of some of their impulses and do things they wouldn't ordinarily do, like increased arguing, driving the car recklessly or shoplifting. A patient taking a BZ should drink very little alcohol and should refrain from drinking within hours of driving a car. Although it is rare for a person with an anxiety disorder to abuse a benzodiazepine, patients with a history of substance abuse report a more euphoric effect from the BZs than do control subjects.
If taken over long periods, the BZs can produce a loss of muscle coordination and some cognitive impairment, especially in the elderly. They also can use the BZs to help with sleep, to control anxiety produced by other drugs or to reduce withdrawal symptoms from other drugs.