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Tapering Of Anti-Anxiety Drugs
Requires Close Monitoring
“I’ve been taking anti-anxiety medication for the last 10 years. I’ve been told that to stop taking it, I need to taper the drugs. Will
I have any withdrawal symptoms?”
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By Dr. Thomas Goldschmidt
Your concern about tapering your anti-anxiety medication is well taken. Chronic use of
anti-anxiety drugs, also known as anxiolytics or tranquilizers, requires careful supervision. As such, the tapering of such medication is best
addressed by your primary care provider or psychiatrist.
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Generally, this class of medication is referred to as
benzodiazepines, and includes drugs such as Valium, Librium, Ativan, Tranxene and Xanax to name a few. Benzodiazepines are cross
tolerant with alcohol and barbiturates, which are also used as tranquilizers. Hence, combining various anti-anxiety medications can produce
symptoms of intoxication. As a group, benzodiazepines are designed to produce a calming effect, depress brain cell function, increase
seizure thresholds, relax
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skeletal muscle or sedate the consumer. Patients often become tolerant to the medication and require more and more drug to achieve the same effects. In this regard, the potential for psychological and physical
dependence and addiction may be high, depending on the individual physiological makeup and abuse tendencies.
Unlike barbiturates such as Amytal, Nembutal,
Luminal, or Seconal, benzodiazepines are less likely to
produce dangerous withdrawal symptoms. Yet, shorter
acting drugs such as Xanax are noted for producing
a withdrawal syndrome that can include seizures. Tapering of Xanax can often take months with minute dose decrements scheduled every
two to three weeks. Accordingly, it is important to notify your new physicians of your use of tranquilizers prior to any surgical procedures or
hospitalization to avoid inadvertent discontinuance of the medication and
dire withdrawal consequences.
With proper supervision, anti-anxiety medication
can be safely administered, providing dramatic relief from panic symptoms, generalized anxiety, obsessive-compulsive behavior, muscle pain, insomnia and situational stressors. Unwittingly, some physicians combine cross-tolerant medication such as Soma, a marketed muscle relaxant structurally similar to the propanediol Meprobamate (Equanil, Miltown). In such cases, patients may facilitate a dependence on their medication and display increasing characteristics of
intoxication.
As with any sedating medication, patients should be advised to consult their physician prior to engaging in
hazardous activity, including driving.
Dr. Goldschmidt is former Chief of Staff at Coral Springs Medical Center.
E-mail him at goldschmidt@theparklander.com
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