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Diazepam - withdrawal

Why have I been prescribed diazepam? If a person stops drinking alcohol after a time of drinking too much they can experience withdrawal effects. These include “the shakes”, sweating, having fits, seeing things which are not there (hallucinations) and feeling anxious and low in mood. They can feel wound up and find it difficult to sleep. These withdrawal effects can be very uncomfortable and in extreme cases can be dangerous if they persist into “DTs” ().

Diazepam is used to help reduce these withdrawal symptoms. It relieves anxiety and tension and aids sleep. Diazepam can also prevent fits. It controls the withdrawal symptoms until the body is free of alcohol and has settled down. This usually takes three to seven days from the time you stop drinking.

What exactly is diazepam? Diazepam is a . This group of medicines is also called or minor tranquillisers. Diazepam has many uses. It can be used to reduce symptoms of anxiety and , as well as to help people come off alcohol. Diazepam should only be prescribed and taken as a short course.

Is diazepam safe to take? Diazepam is safe to take for a short period of time, but it doesn’t suit everyone. Below are a few conditions where diazepam may be less suitable. If any of these apply to you please tell your doctor or key-worker.

 If you have depression or a mental illness  If you have lung disease or breathing problems, or suffer from or trouble  If you take any other medicines or drugs, including those on prescription and bought from a chemist  If you take illicit drugs bought “on the street”  If you are pregnant or breast-feeding

What is the usual dose of diazepam? The dose of diazepam will usually be started at 10-20mg four times a day. This may vary according to your individual assessment. After this time the dose will be cut gradually every one to two days over five to ten days. This is a short course of treatment and will not usually continue longer than two weeks.

During treatment you will be assessed every day for the first few days for symptoms of alcohol withdrawal. Alterations to the dose of diazepam you should take will depend upon these assessments. A blood test may be taken to check your liver is working properly and you may be breathalysed.

How should I take my diazepam? Make sure you read the label on your medicine and the information leaflet that comes with your medicine. Follow this advice carefully. If you have any questions, speak to your doctor or pharmacist. Never change the dose yourself.

The initial dose will be four times a day, which should ideally be equally spaced every four to six hours over the day. Always take your medicine with a full glass of water.

What should I do if I miss a dose? Never change the dose without checking with your doctor. If you forget a dose take it as soon as you remember if it is within a couple of hours of when you should have taken it. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not “double up” on your next dose as this could be dangerous.

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What will happen to me when I start taking diazepam? The diazepam should start to work after a couple of hours; you should feel more relaxed and calmer. You may feel sleepy and this sleepiness may continue for the first few days. You may still experience withdrawal effects despite the diazepam. If this is the case these should be mentioned during your assessment by your key-worker.

Unfortunately, like all medicines there are side effects. Many will go away after a few doses. The table below tells you some of the side effects and what to do about them. Your doctor needs to know if you get side effects, especially anything unusual. Ask your doctor, pharmacist or nurse, if you are worried about anything else that you think might be a side effect.

Side effect What is it? What should I do it happens to me Drowsiness Feeling sleepy or sluggish. This can Don’t drive or use machinery. If you get very drowsy last all day for the first few days miss out a dose. Being unsteady on your feet Discuss with your key-worker or doctor – your dose may need adjusting Aggression or Feeling excitable. You may be over- Discuss this with your key-worker or doctor – your disinhibition talkative, unfriendly or over friendly dose may need adjusting Headache When your head is pounding or painful A mild painkiller such as aspirin or paracetamol may help. If pain is severe or persistent speak to your doctor or key-worker Confusion Your mind is all mixed up Discuss this with your key-worker or doctor – your dose may need adjusting Your blood pressure is too low – this It is not dangerous. Don’t stand up too quickly. If you can make you feel dizzy feel dizzy don’t drive. Loss of memory or difficulty in It is not dangerous, discuss this with your key-worker remembering if you are worried. Rash Blotchy patches anywhere on the skin This is rare. Stop taking – see a doctor now. Respiratory Shortness of breath, wheezing or a Stop taking – See a Doctor now. depression difficulty catching your breath Impaired liver Your liver is not working very well. You Stop taking – See a doctor now. This is a very rare function may get yellowing of the skin or eyes, side effect dark urine, severe stomach cramps, light coloured stools. You may find it difficult to pass urine or Discuss with your key-worker or doctor – your dose emptying bladder takes longer may need adjusting

What about alcohol? It is best to avoid alcohol. Taking alcohol whilst trying to stop drinking makes the diazepam treatment pointless. If you take alcohol on top of diazepam this can make you very drowsy and this could be dangerous.

What about other medicines or drugs? Diazepam does affect your ability to drive or perform skilled tasks. This would be increased by alcohol or any other “downer”, or sleep-inducing medicines, including illicit drugs. Taking these with diazepam can be dangerous. Always check if it is safe to take other medicines with your doctor, nurse or pharmacist.

When I feel better can I stop taking diazepam? If you decide to stop taking diazepam, you should discuss this decision with your doctor before doing so. You may experience withdrawal effects if you stop it suddenly. The withdrawal effects could include that could be dangerous. This is short course of treatment and it is better if you complete it.

This leaflet has been produced by Sussex Partnership Foundation Trust. This leaflet can only give you some information about this medicine. It is not intended to substitute for the expertise or judgement of a doctor, pharmacist or other healthcare professional. It is not an official manufacturer’s Patient Information Leaflet. You might find some other leaflets or books, or the Internet might have more information, but remember the Internet is not always accurate. We would also like to acknowledge Berkshire Healthcare Trust Pharmacy for their help.

Produced June 2007, Updated Dec 09 Reviewed unchanged Dec 12 To be reviewed by Dec 2015