Patients with chronic sleep disorders, anxiety, depression, or pain may request assistance in withdrawing from long term use of pharmaceutical medications when side effects or lack of effectiveness become problematic. Benzodiazepines are especially difficult to discontinue, requiring minimal dose reductions over long periods of time. Withdrawal symptoms can include panic attacks, severe insomnia, tremors, confusion, memory loss, muscle pain and stiffness, perceptual changes, mania, hallucinations, seizures, and suicide.
Case Study
Mr. A is a cancer survivor with a history of complex pelvic injury, fracture of pubic bone, diastasis of symphysis pubis, multiple surgical procedures including abdominal surgery to remove a malignant retroperitoneal tumor, spinal surgery to remove a Schwannoma at L5/S1, removal of an angiolipoma from the left buttock, and most recently, pelvic fusion surgery. Patient also suffers from severe hydronephrosis of the right kidney, and chronic kidney stones. He has managed chronic pain and sleep disturbance with Restoril/temazepam, Tramadol, Flexeril, Vicodin, and Oxycodone. He now feels the temazepam is causing neurological problems, and is having severe insomnia from reducing the dose.