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. 1982 Dec 1;127(11):1093–1096.

Diazepam withdrawal syndrome: its prolonged and changing nature.

C S Mellor, V K Jain
PMCID: PMC1862031  PMID: 7139456

Abstract

The diazepam withdrawal syndrome was studied in 10 patients who had abused the drug for 3 to 14 years. In the previous 6 months their consumption of diazepam had ranged from 60 to 120 mg daily; none had used other drugs during this period. The withdrawal period lasted about 6 weeks. The intensity of the symptoms and signs was high initially, fell during the first 2 weeks, then rose again in the third week, before finally declining. Three groups of symptoms and signs were identified. Group A symptoms occurred throughout withdrawal and included tremor, anorexia, insomnia and myoclonus. Group B symptoms and signs were largely confined to the first 10 days and were those of a toxic psychosis. Group C symptoms reached a peak in the third and fourth weeks of withdrawal and were characterized by sense perceptions that were either heightened or lowered. The symptom groups, the presence of tremor and myoclonus, and the relief of symptoms by a test dose permit diazepam withdrawal to be distinguished from anxiety. The biphasic course of the symptoms is probably related to the pharmacokinetics of diazepam.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BARTEN H. H. TOXIC PSYCHOSIS WITH TRANSIENT DYSMNESTIC SYNDROME FOLLOWING WITHDRAWAL FROM VALIUM. Am J Psychiatry. 1965 Jun;121:1210–1211. doi: 10.1176/ajp.121.12.1210. [DOI] [PubMed] [Google Scholar]
  2. Bond A. J., Hailey D. M., Lader M. H. Plasma concentrations of benzodiazepines. Br J Clin Pharmacol. 1977 Feb;4(1):51–56. doi: 10.1111/j.1365-2125.1977.tb00666.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Braestrup C., Squires R. F. Brain specific benzodiazepine receptors. Br J Psychiatry. 1978 Sep;133:249–260. doi: 10.1192/bjp.133.3.249. [DOI] [PubMed] [Google Scholar]
  4. Dysken M. W., Chan C. H. Diazepam withdrawal psychosis: a case report. Am J Psychiatry. 1977 May;134(5):573–573. doi: 10.1176/ajp.134.5.573. [DOI] [PubMed] [Google Scholar]
  5. Greenblatt D. J., Shader R. I. Dependence, tolerance, and addiction to benzodiazepines: clinical and pharmacokinetic considerations. Drug Metab Rev. 1978;8(1):13–28. doi: 10.3109/03602537808993775. [DOI] [PubMed] [Google Scholar]
  6. HOLLISTER L. E., BENNETT J. L., KIMBELL I., Jr, SAVAGE C., OVERALL J. E. DIAZEPAM IN NEWLY ADMITTED SCHIZOPHRENICS. Dis Nerv Syst. 1963 Dec;24:746–750. [PubMed] [Google Scholar]
  7. Klotz U., Antonin K. H., Bieck P. R. Comparison of the pharmacokinetics of diazepam after single and subchronic doses. Eur J Clin Pharmacol. 1976 Jun 15;10(2):121–126. doi: 10.1007/BF00609470. [DOI] [PubMed] [Google Scholar]
  8. MacLeod S. M., Giles H. G., Bengert B., Liu F. F., Sellers E. M. Age- and gender-related differences in diazepam pharmacokinetics. J Clin Pharmacol. 1979 Jan;19(1):15–19. doi: 10.1002/j.1552-4604.1979.tb01612.x. [DOI] [PubMed] [Google Scholar]
  9. Mandelli M., Tognoni G., Garattini S. Clinical pharmacokinetics of diazepam. Clin Pharmacokinet. 1978 Jan-Feb;3(1):72–91. doi: 10.2165/00003088-197803010-00005. [DOI] [PubMed] [Google Scholar]
  10. Miller F., Nulsen J. Single case study. Diazepam (Valium) detoxification. J Nerv Ment Dis. 1979 Oct;167(10):637–638. doi: 10.1097/00005053-197910000-00010. [DOI] [PubMed] [Google Scholar]
  11. Pevnick J. S., Jasinski D. R., Haertzen C. A. Abrupt withdrawal from therapeutically administered diazepam. Report of a case. Arch Gen Psychiatry. 1978 Aug;35(8):995–998. doi: 10.1001/archpsyc.1978.01770320089008. [DOI] [PubMed] [Google Scholar]
  12. Preskorn S. H., Denner L. J. Benzodiazepines and withdrawal psychosis. Report of three cases. JAMA. 1977 Jan 3;237(1):36–38. [PubMed] [Google Scholar]
  13. Rementería J. L., Bhatt K. Withdrawal symptoms in neonates from intrauterine exposure to diazepam. J Pediatr. 1977 Jan;90(1):123–126. doi: 10.1016/s0022-3476(77)80785-3. [DOI] [PubMed] [Google Scholar]
  14. Rifkin A., Quitkin F., Klein D. F. Withdrawal reaction to diazepam. JAMA. 1976 Nov 8;236(19):2172–2173. [PubMed] [Google Scholar]
  15. Tognoni G., Gomeni R., De Maio D., Alberti G. G., Franciosi P., Scieghi G. Pharmacokinetics of N-demethyldiazepam in patients suffering from insomnia and treated with nortriptyline. Br J Clin Pharmacol. 1975 Jun;2(3):227–232. doi: 10.1111/j.1365-2125.1975.tb01580.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Vyas I., Carney M. W. Letter: Diazepam withdrawal fits. Br Med J. 1975 Oct 4;4(5987):44–44. doi: 10.1136/bmj.4.5987.44-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. de Bard M. L. Diazepam withdrawal syndrome: a case with psychosis, seizure, and coma. Am J Psychiatry. 1979 Jan;136(1):104–105. doi: 10.1176/ajp.136.1.104. [DOI] [PubMed] [Google Scholar]

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