From the Guidelines
Benzodiazepine withdrawal symptoms can be alleviated with supplements such as magnesium aspartate.
Supplements for BZD Withdrawal
- Magnesium aspartate is one of the supplements that has been investigated as an adjunctive pharmacological intervention to facilitate tapering long-term benzodiazepines and mitigate benzodiazepine withdrawal symptoms 1.
- Other supplements and medications that have been studied for their potential to alleviate BZD withdrawal symptoms include carbamazepine, pregabalin, captodiame, paroxetine, alpidem, tricyclic antidepressants, and flumazenil 1.
- However, the evidence for these supplements and medications is limited by heterogeneity and underpowered studies, and therefore, their use should be approached with caution.
- Gradual tapering of benzodiazepines over a period of 8-12 weeks, rather than abrupt discontinuation, is recommended to minimize the risk of withdrawal symptoms 1.
- Psychosocial support and non-pharmacological interventions, such as cognitive-behavioral therapy, problem-solving, and supportive psychotherapy, can also be effective in alleviating BZD withdrawal symptoms 1.
The FDA Drug Labels for benzodiazepine (PO) do not address this question.
From the Research
Supplements for Benzodiazepine Withdrawal Symptoms
There are several supplements that may alleviate benzodiazepine (BZD) withdrawal symptoms, including:
- Gabapentinoids, such as pregabalin, which have been shown to reduce symptoms of anxiety and withdrawal in some studies 2, 3, 4
- Anti-epileptic drugs, which may also alleviate symptoms of withdrawal 2
- Tricyclic antidepressants, which have been found to have a potential benefit in benzodiazepine discontinuation and reduction of withdrawal symptoms 3
- Valproate, which has been shown to have a potential benefit in benzodiazepine discontinuation 3
- Flumazenil, a GABA antagonist, which has been found to reduce symptoms of anxiety and withdrawal in some studies 3
- Magnesium aspartate, which may decrease the proportion of participants discontinuing benzodiazepines 3
- Cyamemazine, which has been found to reduce the proportion of participants that relapse to benzodiazepine use 3
- Captodiame, which has been found to reduce symptoms of anxiety and withdrawal in some studies 3
- Paroxetine, which has been found to reduce symptoms of anxiety and withdrawal in some studies, although the positive effect did not persist until longest follow-up 3
- Carbamazepine, which has been found to reduce symptoms of anxiety 3
- Alpidem, which has been found to decrease the proportion of participants with benzodiazepine discontinuation, but also increased the occurrence of withdrawal syndrome 3
Mechanism of Action
The mechanism of action of these supplements in alleviating BZD withdrawal symptoms is not fully understood, but it is thought to involve the modulation of the GABAergic and glutamatergic systems 4. Gabapentinoids, for example, may attenuate the overactive glutamatergic system during the withdrawal phase by an indirect presynaptic glutamatergic mechanism dependent on the α2δ1 subunit expression 4.
Limitations
It is essential to note that the evidence for the use of these supplements in alleviating BZD withdrawal symptoms is limited, and more research is needed to fully understand their effects 5, 6, 2, 3, 4. Additionally, the quality of the evidence is often low or very low, and the number of trials identified is limited, making it difficult to draw firm conclusions 3.