[Two cases of psychotic state following normal-dose benzodiazepine withdrawal]

J UOEH. 1988 Sep 1;10(3):337-40. doi: 10.7888/juoeh.10.337.
[Article in Japanese]

Abstract

We report two cases of severe withdrawal symptoms after abrupt discontinuation of a long-term normal-dose benzodiazepines (BZD) administration. Case 1, a 61-year-old man, suffered from delirium on the 7th day after abrupt discontinuation of nitrazepam, 10 mg/day. Case 2, a 49-year-old woman, suffered from auditory hallucination on the 4th day and visual cognitive disorder on the 5th day after abrupt discontinuation of nitrazepam, 5 mg/day, and triazolam, 0.5 mg/day. A withdrawal syndrome after discontinuation of normal-dose BZD is uncommon, and a psychotic withdrawal reaction is even more uncommon. We show how a continuous administration of BZD for a period of longer than 6 months and the presence of severe insomnia are risk factors predictive of a psychotic reaction. We also explain the predictive method used to determine the onset time of such a severe state. In the case of a psychotic state, we recommend intravenous diazepam injection. To prevent withdrawal reaction, we also recommend a gradual reduction after administration of normal-dose BZD.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Anti-Anxiety Agents / adverse effects*
  • Cognition Disorders / chemically induced*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nitrazepam / adverse effects
  • Perceptual Disorders / chemically induced*
  • Substance Withdrawal Syndrome*
  • Triazolam / adverse effects

Substances

  • Anti-Anxiety Agents
  • Triazolam
  • Nitrazepam