How to Stop Anxiolytics ?

Taken in the long run, anxiolytics, most often benzodiazepines, have disadvantages that far outweigh their benefits. The risk of dependence is one of those side effects. Deciding to stop these drugs is a first step, but motivated as it is, weaning must always be progressive.

Some people take anxiolytics because they can not manage their anxiety or have just been traumatized. Others because they have a phobia, panic attacks or generalized anxiety. In 84% of cases according to the National Agency for the Safety of Medicines, benzodiazepines are prescribed because they are very effective very quickly.
With a flip side: beyond 12 weeks of treatment, there is a risk of dependence. The good news: Anyone can stop these drugs against anxiety.

First be motivated

"For this to work, we must be committed to really engage," insists Professor Philippe Zerr, member of the Commission of strategies of care of the High authority of health. Knowing the side effects and risks of these long-term medications may be enough to fuel this motivation: memory loss, drowsiness, confusion, convulsions, road accidents or falls in the elderly, or even increased risk of dementia .

Choose the right time to stop anxiolytics

From the moment the decision is made, we are no more than one or two weeks away.

"If you have a lot of worries, it is better to postpone your next vacation or a quieter time, as anxiety, anxiety or sleep disturbances related to this stressful period can not be added to the symptoms of weaning, "says Professor Antoine Pelissolo.

 To wean oneself gradually

The dose reduction should be gradual, and be done in stages to prevent severe withdrawal symptoms (convulsions), and to limit those who, although less severe, can be painful: rebound anxiety, nightmares, insomnia, sweats , headaches, irritability, vertigo ...

To be accompanied by a doctor

It is essential to be accompanied during this period of weaning by a doctor.

• Or his GP: if he knows us well, that he is informed about withdrawal protocols, available for follow-up (an appointment at least every 15 days at the start, then every month until the stop ) and easily reachable in case of problems.
• Either a psychiatrist, preferably addictologist: "If we have many symptoms of lack, made several attempts to stop without success, says Dr. Lawrence Karila. When the follow-up in consultation is very complicated or impossible, a hospitalization of 2 to 4 weeks in an addictology service may be necessary. "

Set a stop schedule with the doctor

It is essential to establish with the doctor a schedule for stopping anxiolytics: it shows the dates of decrease in doses and how many, unusual signs if there are any. "This allows you to adjust the steps and dosages," says Prof. Pelissolo. In the simplest cases, stopping can take 3 or 4 weeks. "But it takes several months when the initial doses are high and the treatment is old. "

For example :

• If you take it for 3 or 4 months, at low dose: you reduce the dosage by half every 8 to 10 days.
• If you have been on treatment for 1 or 2 years: "to a person who takes a Xanax tablet morning, noon and night, quote Professor Zerr, we can propose to halve one of the three taken, choosing the one that seems to him the least problem. Fifteen days later, another half dose is removed and so on until it stops. In case of very troublesome symptoms, we can go back to the upper level. "

Rely on other drugs

Other disorders, which the anxiolytic had soothed, may reappear when stopped, such as phobias, panic attacks or anxiety disorders. "It's important to treat them, but with other non-addictive drugs, such as anti-depressants or, if anxiety causes sleep disturbances, specific antihistamines or melatonin," Pelissolo says. .

Warn your loved ones

If there are symptoms of withdrawal, it is better for them to be prepared not to be taken aback or even frightened. "They can also provide beneficial support, if only by encouraging the person to hold on," says Zerr

Associate relaxation techniques

"The ideal is to combine stopping with relaxation techniques and / or behavioral and cognitive therapy if it is possible, and that can then be used to manage anxiety situations," says Professor Pelissolo . Other tools are not to be overlooked, such as Kardia or Respirelax + apps that offer breathing exercises and cardiac coherence (free on AppStore and GooglePlay).