Withdrawals a tough pill to swallow

Q. I would like to know if there is any way to soften withdrawals from benzodiazapines. I was on Rivotril (clonazepam) for 26 years. I've been off for 15 months and still get widespread shock-like sensations. Your comment would be appreciated.
- W
A. Clonazepam is a benzodiazepine used to treat anxiety and panic disorders, insomnia, and sometimes seizures.
It's effective but long-term use often causes memory loss, cognitive impairment, depression and mood swings.
People who stop chronic benzodiazepine use avoid these effects, but face withdrawal symptoms that range from agitation to full-blown seizures. Those at most risk are high-dose long-term users who stop cold turkey. Withdrawal symptoms wane with time, but some unlucky folks can still have symptoms a year or more down the road. Shock-like sensations have been described as an effect of benzodiazepine withdrawal.
The safest way to stop chronic benzodiazepine use is very gradually, with a slowly tapered dose spread out over months, in co-ordination with your doctor. Your brain has been under sedation for 26 years, and it takes months to years for that physiology to return to normal. Even when it does, you may return to a "normal" that you were not happy with in the first place. This is where ancillary support like psychiatric counselling, addiction specialists, family resources, and even some alternative treatments may have a role. None are a panacea. However, some combination may be effective for you, individually.
Getting you symptom-free may not be realistic, but getting you to a point where you are functional in day-to-day life should be achievable. Medical treatments exist for sensory paresthesias like you describe, such as amitryptiline, gabapentin and capsaicin, but these all have their downsides as well. You should discuss your symptoms with your doctor, to be sure they're not from a disease unrelated to your benzodiazepine withdrawal, such as a neuropathy.
The good news is you've successfully stopped chronic benzodiazepine use and made it through the worst of the withdrawal symptoms. Your residual symptoms should wane with time. While I don't have easy answers for you, I thank you for sharing your experiences so that others might learn from them.
Gary Payinda MD is an emergency medicine consultant in Whangarei.
Have a science, health topic or question you'd like addressed? Email: drpayinda@gmail.com
(This column provides general information and is not a substitute for the medical advice of your personal doctor.)