Fx withdrawal

2 nd deposit – 300 USD – skrill your withdrawals must be transferred to the same card, e-wallet, bank account used for deposit.

Fx withdrawal

Watch our step-by-step guides on how to withdraw in our how to videos.

Please note that in order to request a withdrawal your profile must be fully verified.

Can I withdraw using a different method than the one I used to deposit?

Withdrawals must be made in proportion to the deposits according to the payment method used.

Your withdrawals must be transferred to the same card, e-wallet, bank account used for deposit.

Initial deposit – 600 USD – credit card *3333

2 nd deposit – 300 USD – skrill

Total deposited: 900 USD

Initial withdrawal – 200 USD – must be made using credit card *3333

2 nd withdrawal - 500 USD – 400 USD must be withdrawn using credit card *3333 and 100 USD must be withdrawn using skrill.

Total withdrawn: 700 USD

Please note that in some cases, credit card withdrawals can only be made within 12months of the initial deposit.

How long does it take to process my withdrawal?

All withdrawal requests are processed by our back office department within the same business day , however the time required for the funds to be transferred to your account will depend on the payment method used.

- bank wires: between 3- 5 business days. - credit/debit cards: between 3 – 10 business days. - E – wallets: within 1 business day.

What should I do if the card used to deposit was cancelled/lost?

You will need to email us an official document from the card issuer stating that the card was cancelled or lost and we will then inform you on how to proceed.

Can I still withdraw if I have open positions?

Yes, provided that you have sufficient free margin on your account to cover the withdrawal and any extra fees that may occur.

You can calculate your free margin here.

I’m withdrawing via credit/debit card, are there any more steps I should follow?

If this is your first withdrawal, you should ensure that the withdrawal is made to the same card used to make your initial deposit.

I’m withdrawing via E-wallet, are there any more steps I should follow?

If your e-wallet has already been verified, your withdrawal will be processed automatically.

If you are withdrawing using webmoney, please follow the steps here.

I’m withdrawing via bank-wire, are there any more steps I should follow?

In order to withdraw you will need to verify your bank account by uploading bank statement showing:

- account holder’s name (this should match the name used during registration). - account number.

I’m withdrawing via china union pay, are there any more steps I should follow?

If this is your first withdrawal, you should ensure that the withdrawal payment is made to the same bank account used to make your initial deposit.

You will also need to provide the following via upload or email:

- bank name - bank account number - province and city - your name (this should be written in chinese characters)

How can I cancel my withdrawal request?

You can cancel your request in myfxtm in the ‘transaction history’ tab under the ‘my money’ section by clicking ‘cancel’.

Making a withdrawal

How can I withdraw funds from my account?

Go the withdraw page within the ‘my money’ section in myfxtm.

Select the payment method and click ‘withdraw’.

Select the myfxtm account or wallet you wish to withdraw funds from and complete the necessary fields.

Select a reason for withdrawal and enter the PIN that was to you via email or SMS and click ‘submit’.

Watch our step-by-step guides on how to withdraw in our how to videos.

Please note that in order to request a withdrawal your profile must be fully verified.

Can I withdraw using a different method than the one I used to deposit?

Withdrawals must be made in proportion to the deposits according to the payment method used.

Your withdrawals must be transferred to the same card, e-wallet, bank account used for deposit.

Initial deposit – 600 USD – credit card *3333

2 nd deposit – 300 USD – skrill

Total deposited: 900 USD

Initial withdrawal – 200 USD – must be made using credit card *3333

2 nd withdrawal - 500 USD – 400 USD must be withdrawn using credit card *3333 and 100 USD must be withdrawn using skrill.

Total withdrawn: 700 USD

Please note that in some cases, credit card withdrawals can only be made within 12months of the initial deposit.

How long does it take to process my withdrawal?

- bank wires: between 3- 5 business days. - credit/debit cards: between 3 – 10 business days. - E – wallets: within 1 business day.

What should I do if the card used to deposit was cancelled/lost?

You will need to email us an official document from the card issuer stating that the card was cancelled or lost and we will then inform you on how to proceed.

Can I still withdraw if I have open positions?

Yes, provided that you have sufficient free margin on your account to cover the withdrawal and any extra fees that may occur.

You can calculate your free margin here.

I’m withdrawing via credit/debit card, are there any more steps I should follow?

If this is your first withdrawal, you should ensure that the withdrawal is made to the same card used to make your initial deposit.

I’m withdrawing via E-wallet, are there any more steps I should follow?

If your e-wallet has already been verified, your withdrawal will be processed automatically.

If you are withdrawing using webmoney, please follow the steps here.

I’m withdrawing via bank-wire, are there any more steps I should follow?

In order to withdraw you will need to verify your bank account by uploading bank statement showing:

- account holder’s name (this should match the name used during registration). - account number.

I’m withdrawing via china union pay, are there any more steps I should follow?

If this is your first withdrawal, you should ensure that the withdrawal payment is made to the same bank account used to make your initial deposit.

You will also need to provide the following via upload or email:

- bank name - bank account number - province and city - your name (this should be written in chinese characters)

How can I cancel my withdrawal request?

You can cancel your request in myfxtm in the ‘transaction history’ tab under the ‘my money’ section by clicking ‘cancel’.

Policies & regulation

FXTM brand is authorized and regulated in various jurisdictions.

Forextime limited (www.Forextime.Com/eu) is regulated by the cyprus securities and exchange commission with CIF license number 185/12, licensed by the financial sector conduct authority (FSCA) of south africa, with FSP no. 46614. The company is also registered with the financial conduct authority of the UK with number 600475.

Forextime (www.Forextime.Com/uk) is authorised and regulated by the financial conduct authority with license number 777911.

Exinity limited (www.Forextime.Com) is regulated by the financial services commission of the republic of mauritius with an investment dealer license bearing license number C113012295.

Risk warning: cfds are complex instruments and come with a high risk of losing money rapidly due to leverage. 81% of retail investor accounts lose money when trading cfds with this provider. You should consider whether you understand how cfds work and whether you can afford to take the high risk of losing your money.

Regional restrictions: FXTM brand does not provide services to residents of the USA, mauritius, japan, canada, haiti, suriname, the democratic republic of korea, puerto rico, brazil, the occupied area of cyprus and hong kong. Find out more in the regulations section of our faqs.

Funding & withdrawals

How do I fund my account?

You can easily fund your account by logging in to myaccount and visiting the funding page.

We accept funds by credit card, debit card, paypal and bank transfer. You can add your debit and/or credit cards and easily fund via paypal through myaccount. You can also see the currency-specific bank transfer details in myaccount.

Credit/debit card

Min per transaction**	max per transaction	accepted currencies	type	typical processing time	fees
£100 or currency equivalent	$99,999 or currency equivalent	USD, EUR, CAD, JPY, CHF, AUD, GBP

Paypal

min per transaction**	max per transaction	accepted currencies	typical processing time	fees
£100 (or currency equivalent)	£50,000 (or currency equivalent)	EUR, GBP, USD (all paypal transactions are converted to your account's base currency)	typically immediate, but can extend up to 48 hours	FOREX.Com does not charge for incoming paypal deposits

Wire transfer

Min per transaction**	max per transaction	accepted currencies	typical processing time	fees
none	none	USD, EUR, CAD, JPY, CHF, AUD, GBP	up to 1-2 business days	FOREX.Com does not charge incoming wire fees.

**the minimum initial deposit is £100 or currency equivalent. We recommend that you maintain an adequate excess margin balance above your required margin. Maintaining low excess margin levels in your account may prohibit you from trading certain products or lead to undesired liquidations resulting from an adverse market move.

Can I fund with a personal cheque or business cheque?

No, FOREX.Com UK does not accept cheques as a funding method at this time.

How is my money protected?

In accordance with the financial conduct authority (FCA) rules regarding client monies, all retail client money is held in segregated client money accounts.

We hold all client money with top-tier banks, and have trust letters in place with each of these banks to ensure that our client money remains segregated from the assets of the bank. We use our own funds for hedging client trades, and we never engage in any proprietary trading.

Clients may also be eligible for the financial services compensation scheme, which offers cover up to £50,000 in the event a firm becomes insolvent or ceases trading.

FOREX.Com is part of GAIN capital holdings, a NYSE listed company with a strong balance sheet and experienced management team, serving clients in 140 countries worldwide.

What is third-party funding?

A third party is considered to be anyone who is not an owner of the account.

For the purposes of a funding or withdrawal transaction, the name(s) on the FOREX.Com trading account must be an exact match with the name(s) on the account of the other financial institution.

Can I use more than one card to fund my account?

Yes, you may use multiple cards to fund your account. Keep in mind that withdrawals are processed to the original funding methods. Therefore, a single withdrawal request may be processed via multiple cards.

What should I do if the card I used to fund my account is closed, lost, stolen or not available for withdrawal?

In accordance with our anti-money-laundering policy, we are legally obligated to verify the status of the original funding account before we can process a withdrawal of funds to another source.

In the event that the original funding card account is no longer available, you will need to provide us with evidence of its status, such as an account statement or relative document issued by your bank. Documentation must include the following:

Name of the account holder (must match name on FOREX.Com account)

Last four digits of account number and/or payment to FOREX.Com

Language noting the change of the status of your account

My deposit has been declined. What should I do?

Your bank may decline your transaction for a number of reasons, but we are not told why. These may include:

Insufficient funds

Incorrect expiry date

Incorrect CVC number (the 3-digit security code on the back of your card)

Invalid card number

Out-of-date address details

Incorrect 3DS details

Suspected fraudulent transaction

To resolve this, you will need to contact your card issuer.

Does FOREX.Com accept western union?

No, we do not accept payments through western union.

How will a card deposit appear on my bank statement?

When you deposit funds into your FOREX.Com via a card, it will appear as a purchase.

Why is the amount posted in my account less than the amount I wired?

Your deposit may be reduced by a service fee charged by your bank. FOREX.Com does not charge incoming wire fees.

How do I withdraw funds from my account?

You can request a withdrawal of funds via myaccount.

How will my withdrawal be processed?

Withdrawal requests can be submitted through myaccount and are processed in the order the requests were received.

Funds are returned to the originating account in the following order:

Credit/debit card

Paypal

Wire transfer

Withdrawals

Credit/debit card

processing time	max withdrawal amount	fees
typically within 48 hours	up to £100,000 (or currency equivalent) in 24 hours or the amount funded, whichever is lower	none

Paypal

Processing time	max withdrawal amount	fees
typically within 48 hours	up to £20,000 (or currency equivalent) per transaction or the amount funded, whichever is lower	none

Wire transfer

Processing time	max withdrawal amount	fees
typically within 48 hours	unlimited, once card deposits are refunded	none

*processing time only reflects the time it takes FOREX.Com to complete the withdrawal during normal business hours. Your bank may take additional time to credit the funds to your account.

How do I transfer funds between my existing accounts?

Please contact client services to initiate this request.

What if I have open positions when I submit a withdrawal or transfer request?

A withdrawal of funds will result in a reduction of funds available to be used for margin to maintain open positions. This may result in the liquidation of any or all of your open positions. It is your responsibility to ensure that the account holds enough margin to maintain open positions.

Which currencies can I deposit via paypal?

You can make a deposit if you have a paypal account in EUR, GBP or USD. The money will then be converted to your FOREX.Com account base currency.

Are there any charges for making paypal deposits into my FOREX.Com account?

Funding your trading account via paypal is completely free if depositing in same the base currency.

If the base currency of your trading account is not the same as the funds being deposited via paypal, you will be charged as a conversion fee. You will see this amount before completing the deposit. In some cases, where applicable, your bank may handle this conversion fee, rather than paypal. This conversion charge will be applied by your bank.

Can I make my first deposit via paypal?

Yes, you can make your first deposit via paypal.

Is there a minimum or maximum amount I can deposit via paypal?

The minimum paypal deposit amount is £100. The maximum you can deposit via paypal per transaction is £50,000.

How much can I withdraw in one time?

You can only withdraw up to the same amount deposited via paypal. You cannot withdraw any higher amount than has been deposited via paypal.

The minimum withdrawal amount is £100 or the balance of your account (whichever is less).

The maximum you can withdraw via paypal is £20,000 per transaction, or up to the amount deposited with paypal, whichever is lower.

How long do paypal deposits take?

Please allow up to 48 hours for any paypal deposits. However, this process is usually instant.

How long do paypal withdrawals take?

Please allow up to 48 hours for any paypal withdrawals. However, this process is usually instant.

Can I deposit via multiple paypal accounts?

No. You may only fund your account with one paypal account. Please note the name on your paypal account must exactly match the name on your trading account, otherwise the payment could be rejected.

It's your world. Trade it.

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Cfds are complex instruments and come with a high risk of losing money rapidly due to leverage. 74% of retail investor accounts lose money when trading cfds with this provider. You should consider whether you understand how cfds work and whether you can afford to take the high risk of losing your money.

CFD and forex trading are leveraged products and your capital is at risk. They may not be suitable for everyone. Please ensure you fully understand the risks involved by reading our full risk warning.

FOREX.Com is a trading name of GAIN capital UK limited. GAIN capital UK ltd is a company incorporated in england and wales with UK companies house number 1761813 and with its registered office at devon house, 58 st katharine’s way, london, E1W 1JP. GAIN capital UK ltd is authorised and regulated by the financial conduct authority in the UK, with FCA register number 113942. GAIN capital UK ltd is a wholly-owned subsidiary of stonex group inc.

FOREX.Com is a trademark of GAIN capital UK ltd.

This website uses cookies to provide you with the very best experience and to know you better. By visiting our website with your browser set to allow cookies, you consent to our use of cookies as described in our privacy policy.

FOREX.Com products and services are not intended for belgium residents.

We use cookies, and by continuing to use this site or clicking "agree" you agree to their use. Full details are in our cookie policy.

Drug withdrawal symptoms, timelines, and treatment

According to the centers for disease control, in 2017 more than 11% of americans ages 12 and over used illicit substances within the month before being surveyed. 1

Many abused drugs are associated with the development of significant physiological dependence—especially when consumed in large amounts and for a consistent period. When someone becomes dependent on a substance, they may be at risk of experiencing unpleasant withdrawal symptoms when trying to stop using their drug of choice.

The severity and duration of withdrawal from substance dependence are contingent upon many factors, including the amount of a drug that someone used and how frequently they used it. Unfortunately, withdrawing from drugs is often a profoundly uncomfortable experience that can stall or otherwise complicate recovery efforts. In some instances, unmanaged withdrawal can be dangerous and may require medical care to keep a person safe during their detox period.

Continued abuse of drugs or alcohol interferes with the motivation and reward chemistry and circuitry, resulting in drug cravings and dependence.

Detoxing from one substance may result in different withdrawal symptoms and health risks that evolve over varying time frames when compared with another type of drug. With different types of substances, some withdrawal symptoms can be uncomfortable yet seldom immediately dangerous, while others may be very severe and potentially life-threatening.

For certain types of substances, medical detox is commonly an early part of recovery. As part of a typical medical detox protocol, a team of doctors and nurses can help manage a patient’s withdrawal process to alleviate their discomfort and minimize any risk of dangerous symptoms or withdrawal complications.

What is drug withdrawal?

When someone drinks alcohol or uses certain drugs on a repeated basis, their brain adjusts to the presence of this substance. They become physiologically dependent on their substance of choice and utterly reliant on it to function and feel “normal.”

In people who develop significant levels of dependence, withdrawal from drugs is often an inevitable response to the sudden absence of a drug’s declining concentration. Withdrawal symptoms may develop when a substance-dependent person quits a substance “cold turkey” or substantially reduces how much they are using. During withdrawal, the body is attempting to reach a new state of homeostasis as it dispels the user’s drug of choice. This can result in large fluctuations in brain chemicals and may accompany significant mental and physical health repercussions.

Drug withdrawal may include a combination of physical, mental, and emotional symptoms — some of which can prove dangerous if left unmanaged.

American addiction centers (AAC) ofter unique care for every single patient that walks through our facility doors. Using evidence-bases therapies and treatments our team of medical professionals can help you recover from your substance addiction. Give us a call today to learn more at , or provide your contact information and we’ll call you back at your convince.

How long does withdrawal last?

The precise duration of withdrawal is influenced by which particular substance someone used as well as the magnitude of their dependence on the substance. It may take days, weeks, and – in some cases – months to reach complete resolution of all withdrawal symptoms, depending on various factors and individual differences.

Drug withdrawal timelines

A general overview of certain drugs and their characteristic withdrawal timeline is as follows:

- Short-acting opioids (such as heroin and certain prescription painkillers): short-acting opioid withdrawal symptoms generally begin 8-24 hours after last use and last an average of 4-10 days.
- Longer-acting opioids (such as methadone): for methadone and other longer-acting opioids, it may take 2-4 days for withdrawal symptoms to emerge. Withdrawal will likely fade within a period of 10 days. 2
- Benzodiazepines (such as xanax, valium, klonopin, clonazepam and ativan):withdrawal from benzos begins within 1-4 days, peaking in severity in the first 2 weeks. Protracted withdrawal can last months or years without treatment in some cases 3 .
- Alcohol: the first signs of alcohol withdrawal may appear within several hours after the last drink and peak over the course of 24-48 hours. A risk of seizures may remain high for anywhere from 12 hours to 48 hours after, with certain other risks, such as delirium tremens (dts), remaining a concern for as long as 3 days after the last drink. 5

Heroin & opiate withdrawal

Opioid medications, when used under the supervision of a medical doctor, successfully alleviate physical pain caused by injury, illness, or surgery. Misuse of these drugs can greatly increase the risk of someone becoming physiologically dependent on them.

Acute opioid withdrawal syndrome may include several characteristic symptoms, such as: 3,7

Nervousness or anxiety.

Trouble sleeping.

Frequent yawning.

Flu-like symptoms.

Nausea.

Diarrhea.

Hot and cold flashes.

Runny nose.

Excessive sweating.

Goosebumps.

Muscle cramps/body aches.

Although withdrawal from heroin and other opioids is rarely associated with life-threatening complications, enduring the sometimes markedly unpleasant symptoms can present unnecessary challenges to recovery. The mere discomfort of withdrawal—which some describe as mimicking the flu— can lead to immense physical and psychological distress. 7 left unmanaged, opioid withdrawal can easily drive someone toward immediate relapse, which can derail recovery attempts.

Benzodiazepine withdrawal

These medications are central nervous system depressants, or CNS depressants, and work by increasing inhibitory nerve cell signaling in the brain to help manage certain conditions. 4

Some widely-prescribed benzodiazepines include:

Xanax.

Ativan.

Klonopin.

Librium.

Valium.

When used as prescribed under the care of a physician, benzos can help many people manage anxiety, panic, and certain other conditions. However, if someone misuses benzodiazepines to experience their euphoric effects, their risk of developing a dependence on these drugs escalates.

Cocaine withdrawal

When someone abruptly stops using cocaine, they may experience a severe rebound effect in their mood. A dependent user may experience cocaine withdrawal within the first day of their last use, and their withdrawal symptoms could last weeks.

Cocaine withdrawal is rarely physically dangerous, but may include several distressing psychological symptoms, such as:

Depressed mood.

Nervousness.

Irritation.

Psychotic episodes.

Hallucinations.

Thoughts of self-harm.

Ongoing tiredness or lethargy.

Stimulant withdrawal is unlike withdrawal from most other substances, as there is a lack of many physical symptoms. As a result, withdrawal from cocaine is usually not considered to be life-threatening. Mental health professionals trained in substance abuse and dependency may best treat drug cravings and emotional turmoil associated with withdrawal.

Alcohol withdrawal

Although many people don’t think of alcohol as a drug, it is actually the most prevalently consumed addictive substance in the U.S. People with significant alcohol dependence may be at risk of severe withdrawal and should not attempt to quit alcohol “cold turkey” because of the increased likelihood of seizure development or other withdrawal-associated complications. For many, alcohol withdrawal is uncomfortable, but in some instances, it can also prove life-threatening if not appropriately managed through medical detox efforts.

Alcohol is a central nervous system (CNS) depressant, and abruptly quitting or slowing use after developing dependence can result in potentially dangerous nervous system excitation as the body restores equilibrium. Alcohol withdrawal symptoms may arise within hours of the last drink. Still, some of the more serious risks remain a factor for several days. If you are dependent on alcohol, you may experience some of the following distressing symptoms if you try to quit: 10

Insomnia

Anxiety

Agitation

Nausea/vomiting

Tremors

Seizures

Delirium tremens

Hallucinations

It is not always that straightforward to predict who is at the highest risk for severe withdrawal and withdrawal complications. However, the likelihood of experiencing significant withdrawal increases with the average quantity and frequency of drinking. People with certain concurrent medical issues, a history of polysubstance use, and those who have experienced previous episodes of alcohol withdrawal may be at additional risk.

While alcohol withdrawal can start within the first few hours after the last drink, delirium tremens may not start for an additional few days, and appear suddenly, making alcohol withdrawal safest when monitored around the clock by a medical professional.

Ambien

Antidepressants

Ativan

Clonazepam

Club drugs

Cocaine

Codeine

Ecstasy

Hydrocodone

Marijuana

Meth

Opiates

Oxycodone

Oxycontin

Suboxone

Tramadol

Valium

Vicodin

Xanax

When is drug detox necessary?

There are certain factors to consider when deciding whether someone should seek medical detox to manage withdrawal.

Withdrawal can be a challenging, and sometimes dangerous, time for someone who is first getting sober. If you’re thinking of getting sober, it’s recommended that you seek medical professionals’ guidance, who may recommend a medical detox. This way, once your withdrawal symptoms appear, they can be managed appropriately by trained medical staff. Withdrawal management is a large part of the medical detox process. It refers to the medical and psychological care of patients going through drug withdrawal. 8

With many substances, medical detox provides the safest, most comfortable setting for withdrawal management. While in detox, patients can safely rid their bodies of the toxic influence of substances under medical professionals’ care. These medical professionals may monitor vital signs, such as high body temperature or high blood pressure, and administer medications to prevent or manage severe symptoms.

The goal of detox is to reach a state of safety and a comfortable level of mental and physical stability. Someone addicted to alcohol, opioids, benzodiazepines, and other sedatives commonly benefit from undergoing medical detox to safely manage withdrawal with the fewest number of adverse consequences. Many facilities also offer same day admission detox for cases that need attention sooner rather than later.

What are the medications used in drug detox?

To stabilize someone in withdrawal from certain substances at the start of a longer-term treatment for substance use disorders (suds), medical professionals may administer different medications to ease symptoms and decrease the risk of complications.

For example, some medications that may be used during opioid detox include: 7

Clonidine: A medication used to lessen the moderate symptoms of opioid withdrawal, including sweating, vomiting, chills, and insomnia.

Buprenorphine: an FDA-approved partial opiate antagonist medication used for mild-to-severe opioid use disorder that controls cravings and lessens withdrawal symptoms.

Methadone: A long-acting, full opioid agonist medication used to stabilize and maintain people in recovery from opioid use disorder (OUD).

Medications for alcohol and sedative withdrawal management:

For the management of acute alcohol withdrawal, benzodiazepines are commonly administered for seizure prophylaxis and other symptomatic management, before being tapered off throughout the detox period. 8

With some types of benzodiazepine dependence, a relatively long-acting benzodiazepine (e.G., diazepam, chlordiazepoxide) will first be substituted for the benzodiazepine having been previously used. Then, it will be tapered slowly to ease withdrawal over a more extended amount of time. 8

Different drugs have varying timelines, symptoms, and risks. Treatment must be individually tailored to treat withdrawal from the specific drug, or drugs, that someone is dependent on.

One of the primary goals of medical detox is to facilitate continued, longer-term treatment efforts after the withdrawal period have been successfully managed. Detox, though often hugely important, is not a substitute for additional rehabilitation efforts, which will include ample behavioral therapeutic interventions and any continued medical care.

Residential, or inpatient, substance abuse treatment often provides the most comprehensive care, and medical detox is the ideal choice for helping make withdrawal from drugs as comfortable as possible.

Your addiction treatment and rehab at american addiction centers could be covered by your insurance provider, give us a call today at to learn more or verify your insurance below.

Fx withdrawal

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Coronavirus:

About sleeping pills and minor tranquillisers

Before taking them

About benzodiazepines

Side effects of benzodiazepines

Withdrawal effects of benzodiazepines

Comparing benzodiazepines

Sleeping pills

Anti-anxiety medication

Sleeping pills and minor tranquillisers A-Z

Useful contacts

About sleeping pills and minor tranquillisers

Before taking them

About benzodiazepines

Side effects of benzodiazepines

Withdrawal effects of benzodiazepines

Comparing benzodiazepines

Sleeping pills

Anti-anxiety medication

Sleeping pills and minor tranquillisers A-Z

Useful contacts

What withdrawal problems can benzodiazepines cause?

If you take benzodiazepines as recommended, and take them as a one-off dose, you would not normally have any problems in stopping them.

But if you have taken benzodiazepines regularly over a long period of time, you could become physically addicted or psychologically dependent on them. For example, you may experience physical withdrawal symptoms if you stop or reduce your dose, or you may feel that you cannot cope with your day-to-day life unless you take them.

The longer you stay on benzodiazepines, the more likely it is that you will find it difficult to stop taking them and the greater your risk of withdrawal symptoms.

Short-acting benzodiazepines (which are most likely to be taken as sleeping pills) can be particularly difficult to come off if you have been taking them for a long time.

If you want to stop taking benzodiazepines, it's important to reduce the dose gradually, and to get as much information and support as possible. You are more likely to experience withdrawal symptoms if you stop or reduce your dose suddenly. (for more information, see coming off psychiatric drugs).

"eventually my doctor weaned me off it, very slowly, over months. Which was hard, as I really liked being on it. But I knew it was the right thing to do."

Possible withdrawal symptoms

Withdrawal symptoms can occur several hours after taking a short-acting benzodiazepine, and up to three weeks after taking a long-acting benzodiazepine. If you have taken benzodiazepines for a long time, symptoms can last for weeks or months.

Withdrawal symptoms may include:

Abdominal cramps

Agoraphobia (fear of crowded places)

Increased anxiety

Physical symptoms of anxiety (muscle tension, tight chest, palpitations, fast heartbeat, sweating, trembling or shaking)

Blurred vision

Depression

Difficulty sleeping

Dizziness

Face and neck pain

Headaches

Inability to concentrate

Increased sensitivity to light, noise, touch and smell

Loss of interest in sex

Loss of appetite

Nausea (feeling sick)

Nightmares

Panic attacks

Restlessness

Sore eyes

Sore tongue and metallic taste

Tinnitus (ringing in the ears)

Tingling in the hands and feet

Unsteady legs

Vomiting (being sick)

Weight loss.

Severe withdrawal symptoms can include:

Burning sensations in the skin

Confusion

Depression (severe)

Depersonalisation (feeling detached from your surroundings)

Derealisation (feeling out of touch with reality)

Hallucinations

Memory loss

Muscle twitching

Paranoia and delusions (strongly held beliefs that other people don't share)

Seizures (fits).

Broken sleep with vivid dreams may continue for a while after you have come off the drug.

If you withdraw from benzodiazepines suddenly, this can cause serious symptoms including:

Confusion

Psychosis (symptoms such as seeing or hearing things that others don't)

Seizures (fits)

A condition resembling delirium tremens (caused by alcohol withdrawal) with symptoms including a rapid heartbeat, sweating, high blood pressure, tremor (shaking), hallucinations and agitated behaviour.

Alcohol withdrawal symptoms

Alcohol withdrawal symptoms can be extremely dangerous. Find out what they are and what you should do if you are experiencing them.

Withdrawal symptoms are almost always a feature of alcohol dependence. They are potentially dangerous and should be treated as a serious warning sign that you are drinking too much. Find out what these symptoms are, what causes them and what to do if you’re experiencing them.

What are alcohol withdrawal symptoms?

If you get any of the following after drinking heavily, it’s likely you’re experiencing alcohol withdrawal symptoms.

Physical symptoms of alcohol withdrawal

Hand tremors (‘the shakes’)

Sweating

Nausea

Visual hallucinations (seeing things that are not actually real)

Seizures (fits) in the most serious cases

Psychological symptoms of alcohol withdrawal

Depression

Anxiety

Irritability

Restlessness

Insomnia (difficulty sleeping)

Withdrawal symptoms are dangerous and you should seek medical attention if you or someone you’re looking after is experiencing repeated vomiting, severe shaking or hallucinations / confusion.

Withdrawal symptoms and alcohol dependency

If you‘re experiencing withdrawal symptoms, it’s a sign that you are becoming physically dependent on alcohol. Alcohol dependence, sometimes known as ‘alcoholism’, is the most serious form of drinking problem and can lead to a whole range of serious health problems. People who are suffering from alcohol dependence may experience a strong, often uncontrollable, desire to drink and feel they’re unable to function without alcohol.

If you’re experiencing these symptoms several days a week, it’s very likely you are already dependent on alcohol.

You must seek medical help - talk to your GP about how to reduce your drinking, and find out more about alcohol dependence and how other organisations can help.

Relieving symptoms of alcohol withdrawal

If you have regular withdrawal symptoms, you will almost certainly need medical supervision to help you reduce or stop your drinking, and prescription medication, to avoid the danger of having a fit, which could result in permanent injury or death.

Although severe withdrawal symptoms can take up to a year to fully recover from, most people feel better within 3-7 days of stopping drinking. The first 48 hours are likely to be the worst.

To relieve your symptoms once you’ve stopped drinking:

Keep yourself hydrated with plenty of non-alcoholic drinks (but avoid caffeine)

Try to eat regularly

Your GP may prescribe medication to help relieve your symptoms

For some people, insomnia caused by stopping drinking can be challenging, resulting in the urge to start drinking again ‘to help get off to sleep’. If you experience this, remember that your sleep patterns will almost certainly start to return to normal once your brain recovers its normal functions.

What causes alcohol withdrawal symptoms?

Withdrawal symptoms are caused by the way your brain reacts when you drink heavily. Alcohol affects the area of the brain responsible for what’s known as the ‘fight or flight’ function. This is the way in which our brains respond to danger, preparing us to either fight or run away.

When you drink alcohol, the fight or flight response in your brain is suppressed, making you feel relaxed. And when you stop drinking, the alcohol gradually leaves your brain as your body processes it. But if you regularly drink excessively, the alcohol’s effect on your brain’s chemical balance can mean you go straight into fight or flight mode as the alcohol leaves your brain, even when there’s no danger present 1 .

Withdrawal symptoms – both the psychological ones (e.G. Anxiety) and the physical ones (e.G. The shakes) are all caused by your brain going into fight or flight mode.

The more you drink, the more you’re likely to be affected by withdrawal symptoms. Alcohol withdrawal symptoms are most likely to be experienced by people drinking 8 or more units of alcohol, 5 or more nights a week.

What will happen if you don’t reduce your drinking?

If you continue to drink excessively, regularly, despite experiencing withdrawal symptoms, you may find your symptoms get more and more severe. This is known as the kindling effect 2 .

Doctors and scientists don’t yet fully understand how this process works. However, you must take action to reduce the amount you drink if you’re experiencing withdrawal symptoms, to prevent them getting worse.

Find out more about how to cut down your drinking:

Fx withdrawal

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About antidepressants

How antidepressants can help

Before taking antidepressants

Side effects of antidepressants

Withdrawal effects of antidepressants

Antidepressants in pregnancy

Alternatives to antidepressants

Comparing antidepressants

Useful contacts

Antidepressants A-Z

About antidepressants

How antidepressants can help

Before taking antidepressants

Side effects of antidepressants

Withdrawal effects of antidepressants

Antidepressants in pregnancy

Alternatives to antidepressants

Comparing antidepressants

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Antidepressants A-Z

What withdrawal effects can antidepressants cause?

All antidepressants can cause withdrawal effects. These are symptoms that can happen when you reduce your dose or stop taking the drug.

This page lists some of the possible withdrawal effects for different types of antidepressant. You won't necessarily get any of these symptoms, but many people do experience some of them:

Ssris and snris withdrawal effects

Symptoms that may feel new to you

Dizziness or vertigo

Electric shock sensations in head

Flu-like symptoms

Problems with movement, such as problems with balance or walking, or involuntary movements

Sensory disturbance, such as smelling something that isn't there

Stomach cramps

Strange dreams

Tinnitus (ringing in the ears).

Symptoms that may feel like your original problem

Anxiety

Crying spells

Depersonalisation (feeling detached from your surroundings)

Depression

Disturbed sleep

Fatigue (feeling very weary)

Mania

Mood swings

Poor concentration and memory

Suicidal thoughts.

Anxiety

Fast or irregular heartbeat

Flu-like symptoms, such as aching muscles, chills, headaches, nausea (feeling sick) and sweating

Insomnia (inability to sleep)

Low blood pressure

Problems with movement, such as problems with balance or walking, or involuntary movements

Restlessness

Spontaneous orgasm

Strange dreams.

Maois withdrawal effects

Agitation

Difficulty thinking

Disturbed sleep

Extreme sleepiness

Hallucinations

Irritability

Psychotic experiences, such as paranoid delusions

Problems with movement

Strange dreams

Unsteadiness.

"I was worried about not being able to come off them. My doctor helped me to come off them in a controlled way, and apart from one dip just after I stopped taking them, I've been pretty OK since."

Can switching antidepressants help with withdrawal?

If you've been taking a drug with a short half-life, you may experience problems with withdrawal symptoms. In this case, it might be possible for you to switch to a similar drug, but with a longer half-life. You may find this drug easier to come off. For example, this may be switching from an SSRI with a short half-life to another SSRI with a longer half-life.

To compare the half-lives of all antidepressants, see our page on comparing antidepressants.

"[when] I thought I should try to manage without the antidepressant, I did not manage to come off them, which I was incredibly harsh on myself about… I was then on [an antidepressant] until I had been well for a number of years, and then, with the help of my GP, I reduced and stopped the medication."

More information about withdrawal effects

You can find out about the withdrawal effects of specific antidepressants from the british national formulary (BNF) A-Z list of drugs. Or you can speak to your doctor or pharmacist with any questions or concerns you have about the withdrawal effects of antidepressants.

Our pages on coming off psychiatric medication have more information about withdrawing from your medication. This includes help with making the decision whether to come off, and how to come off your medication safely. If you decide to come off your medication, our page on alternatives to antidepressants has ideas on managing your mental health without medication.

8 symptoms of caffeine withdrawal

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Caffeine is the world’s most commonly consumed psychoactive substance.

It functions as a central nervous system stimulant, meaning it affects neural activity in the brain and increases alertness while reducing fatigue ( 1 ).

If the body becomes dependent on caffeine, eliminating it from the diet can cause withdrawal symptoms that typically begin 12–24 hours after stopping caffeine.

Caffeine withdrawal is a recognized medical diagnosis and can affect anyone who regularly consumes caffeine.

Here are 8 common signs and symptoms of caffeine withdrawal.

Headaches are among the most commonly reported symptoms of caffeine withdrawal.

Caffeine causes blood vessels in the brain to constrict, which slows blood flow.

One study found that just 250 mg (less than three cups of coffee) can reduce cerebral blood flow by as much as 27% ( 2 ).

Since caffeine consumption causes blood vessels to narrow, reducing or stopping intake allows blood vessels to open up and increases blood flow to the brain.

This sudden change in blood flow can cause painful withdrawal headaches that can vary in length and severity as the brain adapts to the increase in blood.

Headaches will subside as the brain adapts to this increase in blood flow.

Even though caffeine withdrawal can cause headaches, caffeine is used to treat certain types of headaches like migraines.

Caffeine helps enhance the power of pain-relieving medications and reduces headache pain when consumed on its own ( 3 ).

Eliminating caffeine causes increases blood flow to the brain, which can cause headaches in some people.

Many people depend on a daily cup of coffee to give them an energy boost.

Caffeine helps increase alertness and reduce fatigue by blocking receptors for adenosine, a neurotransmitter that can make you feel drowsy ( 4 ).

This is also why it has been proven to enhance athletic performance, improve energy and reduce chronic fatigue ( 5 ).

However, eliminating caffeine from your diet can have the opposite effect, causing drowsiness and fatigue.

For example, a study in 213 habitual caffeine consumers demonstrated that abstaining from caffeine for 16 hours caused increased feelings of fatigue.

What’s more, those who consumed caffeine daily had more severe withdrawal symptoms, including fatigue, than those who only consumed it a few times a week ( 6 ).

Additionally, its energizing effects only last in your system for about four to six hours, which may lead you to reach for multiple cups of coffee or energy drinks throughout the day to maintain alertness.

This can lead to excessive intake of and dependence on caffeine and make withdrawal symptoms much worse.

Coffee acts as a stimulant in the body and weaning off of it can make you feel tired and drowsy.

Caffeine is a stimulant that increases heart rate, blood pressure and the stress hormones cortisol and epinephrine ( 7 ).

In people who are sensitive to caffeine, just one cup of coffee can cause them to feel jittery and anxious.

While consuming caffeine can cause feelings of anxiousness, cutting it out can cause this side effect as well.

Anxiety is a commonly reported symptom in people who withdraw from regular caffeine consumption.

The body can become mentally and physiologically dependent on it, causing feelings of anxiety.

Plus, if you consume the majority of your caffeine in the form of soda or sugar-sweetened coffee, the sudden reduction in sugar may make caffeine withdrawal-induced anxiety even worse.

Animal studies suggest that suddenly removing sugar from the diet after a long period of sugar consumption can cause symptoms of anxiety ( 8 ).

The body can become both physically and psychologically dependent on caffeine. This can lead to feelings of anxiety when withdrawing from it.

One of the main reasons that people choose to consume caffeine in the form of coffee, tea or energy drinks is to boost concentration.

Caffeinated beverages are commonly consumed before tests, athletic events or presentations to improve focus.

Caffeine increases levels of adrenaline, a hormone produced by the adrenal glands as part of the body’s normal reaction to stress ( 9 ).

It also boosts the activity of the excitatory neurotransmitters dopamine and norepinephrine ( 10 ).

This combination of reactions raises heart rate and blood pressure and stimulates the brain, causing increased alertness and improved focus.

Phasing out caffeine can negatively impact concentration as your body struggles to become accustomed to functioning without it.

Caffeine increases concentration by increasing levels of certain neurotransmitters and hormones. Quitting or cutting back can cause you to have difficulty focusing on specific tasks.

Caffeine is well known for its ability to elevate mood.

It’s ability to block adenosine not only increases alertness but also has been found to improve mood.

One study in people who consumed caffeine regularly found that consuming 0.68 mg per pound (1.5 mg per kg) of body weight led to a more positive mood, compared to a placebo ( 11 ).

Additionally, many studies have linked regular caffeine consumption to a reduced risk of depression.

For example, a large study in over 50,000 women found that women who drank four or more cups of coffee per day had a 20% lower risk of depression than women who drank little or no coffee ( 12 ).

The stimulant effects of caffeine can lead to feelings of well-being and increased energy, which go away when caffeine intake ends ( 13 ).

For this reason, your mood may take a hit if you decide to quit caffeine.

Caffeine causes increased alertness and can boost feelings of well-being. For regular caffeine consumers, cutting it out may lead to a depressed mood.

It’s common for regular coffee drinkers to be cranky before their morning cup of joe.

The caffeine in coffee may be the culprit for this feeling of irritability.

Because coffee only lasts in the system for four to six hours, withdrawal-like symptoms like irritability can occur after a night’s rest ( 14 ).

Coffee drinkers are used to the mood-enhancing effects of caffeine, as well as the shot of energy they receive.

For some, weaning off caffeinated beverages like coffee causes them to become irritable and moody.

In fact, it may be difficult for heavy caffeine users to cut back on the amount they are accustomed to without negatively impacting their mood.

In a study in 94 caffeine-dependent adults, 89% of participants reported that although they desired to cut back on caffeine, they had been unsuccessful in their efforts due to withdrawal symptoms, including irritability and anger ( 15 ).

People who are physically or psychologically dependent on caffeine may experience irritability or anger when trying to abstain from this stimulant.

Though not as common as other symptoms, those who have a serious dependency on caffeine can experience tremors in cases of caffeine withdrawal.

Since caffeine is a central nervous system stimulant, common side effects of drinking too much include feeling jittery or anxious and having shaky hands ( 16 ).

In fact, those with anxiety disorders are often advised against consuming caffeine to avoid worsening feelings of anxiousness ( 17 ).

However, for people who consume large amounts of caffeine daily, quitting cold turkey can also lead to tremors.

Tremors related to caffeine withdrawal typically occur in the hands and should only last for two to nine days.

If you are experiencing hand tremors that last longer than nine days, consult your doctor to rule out other causes.

Both consuming too much caffeine and caffeine withdrawal can cause hand tremors in certain people.

Most everyone who consumes caffeinated beverages and foods is looking for a way to improve lagging energy levels.

Lifestyle factors like poor sleep, demanding jobs and unhealthy diets can drain energy, causing many people to reach for external sources of energy like coffee and energy drinks to revive them.

Caffeinated beverages are often used as a crutch to deliver the energy needed to make it through the day or compensate for lack of sleep.

Sipping on a cup of coffee or energy drink boosts concentration, increases heart rate and increases blood sugar, leading to feelings of increased physical and mental energy.

These desired effects can lead to caffeine dependence, causing the need for more and more caffeine to produce the same energy boost ( 18 ).

This is why low energy is a common complaint of people who are reducing or eliminating caffeine.

Caffeine is a stimulant that causes increased energy, alertness and concentration. Withdrawing can cause low energy in some people.

Symptoms of caffeine withdrawal should only last between two and nine days, with peak intensity of symptoms occurring 24–51 hours after caffeine is cut out ( 19 ).

While these symptoms are usually short-lived, they can be uncomfortable and make life difficult.

Fortunately, there are ways to reduce the chances of experiencing these unpleasant side effects.

Try the following tips to reduce or completely avoid symptoms of caffeine withdrawal.

Cut back slowly: quitting cold turkey can shock the body and make withdrawal symptoms worse. Gradually weaning off caffeine can reduce the chances of experiencing unpleasant side effects.

Reduce caffeinated beverages: if you’re used to drinking full-strength coffee, start drinking half-decaf, half-regular coffee to slowly reduce your dependence. Even better, swap one of your coffees for a decaf herbal tea. Shop for herbal tea online.

Stay hydrated: drinking enough water is crucial when cutting out caffeine. Dehydration can worsen symptoms of withdrawal, such as headache and fatigue ( 20 ).

Get enough sleep: to combat fatigue, try getting the recommended seven to nine hours of sleep per night ( 21 ).

Boost energy naturally: if your energy levels have taken a hit after giving up caffeine, try incorporating natural sources of energy like exercise, nutrient-dense foods and stress reduction techniques into your routine.

Summary slowly cutting back on caffeine, staying hydrated, getting enough sleep and finding alternative sources of energy are ways to decrease caffeine withdrawal symptoms.

Caffeine is a widely consumed stimulant that can cause withdrawal-like symptoms in some.

Caffeine withdrawal can occur in anyone who regularly consumes caffeine and then abruptly discontinues its use.

Common symptoms include headache, fatigue, low energy, irritability, anxiety, poor concentration, depressed mood and tremors, which can last anywhere from two to nine days.

Thankfully, there are ways to reduce these symptoms, including cutting back on caffeine gradually, staying hydrated, getting plenty of sleep and finding ways to naturally boost your energy.

Although caffeine withdrawal may seem unbearable at first, this temporary reaction is just a bump in the road to limiting your dependence.

Steroid drug withdrawal symptoms, treatment, cure, and prevention

Steroid drug withdrawal facts

Synthetic cortisone medications (corticosteroids) simulate cortisol, a naturally occurring, anti-inflammatory hormone produced by the adrenal glands. Such drugs (for example, prednisone) have since benefited many, but are not without potential side effects.

The two major problems related to continuous steroid treatment are
1. Drug side effects and
2. Symptoms due to changes in the balance of normal hormone secretion (withdrawal symptoms).

The production of corticosteroids is controlled by a "feedback mechanism," involving the adrenal glands, the pituitary gland, and brain, known as the "hypothalamic-pituitary-adrenal axis" (HPAA).

Using large doses for a few days, or smaller doses for more than two weeks, leads to a prolonged decrease in HPAA function.

Steroid use cannot be stopped abruptly; tapering the drug gives the adrenal glands time to return to their normal patterns of secretion.

Withdrawal symptoms and signs (weakness, fatigue, decreased appetite, weight loss, nausea, vomiting, diarrhea, abdominal pain) can mimic many other medical problems. Some may be life-threatening.

Tapering may not completely prevent withdrawal symptoms. Steroid withdrawal may involve many factors, including a true physiological dependence on corticosteroids.

Patients should carry a list of all their medications in their wallet to alert medical personnel in case of emergency.

Supplementation with corticosteroid medication may be needed during periods of stress (such as surgery), even up to a year after stopping corticosteroid therapy.

Diagnosis of steroid withdrawal can be difficult. Diagnosis is easier if patients indicate they have recently stopped or decreased a steroid medication, such as prednisone or prednisolone.

Treatment of steroid withdrawal is tailored to the individual. Treatment usually involves steroid administration that is decreased gradually over weeks to months.

Physicians who treat steroid withdrawal include primary care physicians, endocrinologists, internal-medicine specialists, and others.

The prognosis of steroid withdrawal, if diagnosed early and treated appropriately, is usually good.

It is possible to prevent steroid withdrawal by using steroids over short lengths of time. Patients who use steroids for lengthy periods of time may prevent steroid withdrawal by slowly tapering or weaning the dose of the steroid under the direction of a physician.

Consequences of steroid abuse

It is possible to develop a physiological dependence upon steroids. Taking steroid drugs affects the functioning and hormone secretion pattern of the adrenal glands, since these glands are the source of many natural steroid hormones. For this reason, when doctors prescribe steroids, their discontinuation is always tapered (gradually taking smaller doses) to allow the adrenal glands to return to their normal pattern of function and secretion. Likewise, abrupt discontinuation of anabolic steroid use can also result in withdrawal symptoms that can be dangerous and even potentially fatal.

Are steroids anti-inflammatories?

Research conducted by edward calvin kendall at the mayo clinic in the medical use of cortisone led to a nobel prize in 1950. The drug simulated cortisol, a naturally occurring, anti-inflammatory hormone produced by the adrenal glands. Such synthetic corticosteroid drugs (prednisone, prednisolone, and many others) have since benefited patients and are commonly used to treat many conditions, including:

However, there are serious side effects. There are two concerns with steroid side effects. Continuous, long-term steroid treatment are drug side effects, and symptoms due to changes in the balance of normal hormone secretion.

Symptoms from an imbalance of hormone secretion typically results from taking doses greater than our body's natural production (about the equivalent of 7.5 mg of prednisone per day). Once patients begin to decrease or discontinue the dose, withdrawal symptoms may occur. Thus, steroids are typically given for the shortest possible time possible.

Short-term steroid use is commonly without significant side effects and is often a crucial treatment for a variety of issues, including:

Moreover, short-term use does not induce steroid withdrawal.

SLIDESHOW

What are steroid withdrawal symptoms and signs?

Withdrawal symptoms usually appear after extended use of steroids with rapid/sudden stopping of the drug. These steroids include glucocorticoids, anabolic steroids in topical, injectable, and transdermal forms. The following symptoms and signs may occur in individuals who are withdrawing from taking steroids:

Weakness

Fatigue

Decreased appetite

Weight loss

Nausea

Vomiting

Diarrhea

Abdominal pain

Low blood pressure (hypotension)

Dizziness or fainting

Low blood sugar (hypoglycemia)

Menstrual changes

Less often, joint pain, skin changes, muscle aches, fever, mental changes, or elevations of calcium may be noted. Dehydration and electrolyte imbalances may occur. Decrease in gastrointestinal contractions can occur, leading to dilation of the intestine (ileus). Steroid withdrawal symptoms mimic many other medical problems.

Latest medications news

Daily health news

How do you taper off steroids? Do they affect your adrenal glands?

Over the years, researchers began to learn why some patients develop symptoms of decreased adrenal function, while others never do. The production of corticosteroids is controlled by a "feedback mechanism," involving the adrenal glands, the pituitary gland, and brain, known as the "hypothalamic-pituitary-adrenal axis" (HPAA). The continuous administration of corticosteroids inhibits this mechanism, causing the HPAA to "hibernate."

We now know that the amount of the drug needed to suppress the HPAA varies from person to person. As a general rule, using large doses for a few days, or smaller doses for more than two weeks, leads to a prolonged decrease in HPAA function. Typically, there are no withdrawal symptoms with a 5-day moderately high dose burst of steroids.

Thus, steroid use cannot be stopped abruptly. Tapering the drug gives the adrenal glands time to return to their normal patterns of secretion. (it may take a period of time for things to get completely back to normal). How quickly steroids can be tapered depends on continued control of the underlying disease with decreasing doses, and on how quickly our body adjusts to the need to produce its own hormones. If things go well, 4 to 6 weeks (or longer) is a reasonable period.

Unfortunately, tapering may not always completely prevent withdrawal symptoms. Present thinking suggests that steroid withdrawal may involve many factors, including a true physiological dependence on corticosteroids. Further, tests of HPAA function do not always correlate with a patient's symptoms, and these tests are of no value while taking steroids. Therefore, it can be difficult to determine the true cause of a patient's symptoms or reaction to stress (for example, from a disease flare-up, procedure, or surgery). Restarting or increasing dosage may be the only solution.

Taking steroids every other morning gives the body a better chance to recover function. The day without the hormone allows natural stimulation of the hypothalamus and pituitary glands. Thus, alternate-day therapy is ideal, if possible, once the disease is under control. It is still not clear whether new steroids being developed will be available to decrease the risks of side effects and HPAA suppression.

We must assume that all patients exposed to steroid therapy for even a short time have diminished HPAA function. Patients who have taken steroids noticing any of the above or other unusual symptoms should notify their doctor. Keep in mind that some medications or alcohol can increase the need for larger steroid doses. You should carry a list of all your medications in your wallet to alert medical personnel in case of emergency. This is especially important if you are receiving steroid therapy or have recently stopped taking steroids. Supplementation may be needed during periods of stress, even up to a year after discontinuing corticosteroid therapy.

QUESTION

What tests do doctors use to diagnose withdrawal from steroids?

Because the symptoms of steroid withdrawal are varied and nonspecific, health care professionals may have some difficulty diagnosing this problem. However, the best way to diagnose steroid withdrawal is to have a good history and physical examination from the patient, with emphasis on medications such as steroid usage in the recent past that have been discontinued. Patients can help if they indicate to their doctors they have stopped steroids recently. Other tests that may aid in the diagnosis are the cortisol level, serum calcium level, CBC, electrolyte levels, BUN level, and creatinine level.

Which types of specialists treat steroid withdrawal symptoms?

In addition to primary care physicians, internal-medicine specialists, endocrinologists, addiction specialists, emergency physicians, hospitalists, and hospital-based pharmacists can participate in treating steroid withdrawal.

By clicking submit, I agree to the medicinenet's terms & conditions & privacy policy and understand that I may opt out of medicinenet's subscriptions at any time.

What is the treatment for steroid withdrawal?

In general, steroid withdrawal is treated by administering steroids to decrease or eliminate withdrawal symptoms, then gradually decreasing the amount of steroids given so the body can adjust to synthesizing steroids normally. Each individual patient is different, so the physicians will take into account the patient's symptoms, steroid type (for example, hormonal steroids can be reduced faster than other steroid medications), and the patient's compliance. The weaning time is highly variable and may take a few weeks to up to a year or so depending on the patient's dependency, the strength and type of steroid administered, and underlying medical problems.

Some patients may require increases in their steroids during withdrawal with stressful conditions such as emergency surgery. Such increases are usually very short-term increases.

What is the prognosis of steroid withdrawal?

The prognosis of steroid withdrawal, if quickly recognized and treated, is usually good. The prognosis begins to decline if the steroid withdrawal goes unrecognized and complications such as electrolyte abnormalities, dehydration, and other signs and symptoms lead to further health problems, or if the patient becomes noncompliant with treatment protocols.

Can you prevent steroid withdrawal?

Yes, it is possible to prevent steroid withdrawal. The best way to prevent steroid withdrawal is to be sure to use steroids conservatively and for the shortest period possible. Short-term use of steroids (time period varies with the type of steroid and its amount administered -- usually days to weeks) usually does not trigger steroid withdrawal. However, with both short- and longer-term use of steroids, steroid withdrawal may be avoided in most patients by tapering the dose over time. This method may also prevent steroid withdrawal in the majority of patients.

Stopping antidepressants: is it withdrawal?

When antidepressants that affect the brain chemical serotonin are suddenly stopped, the body may respond with physical and emotional symptoms caused by the sudden absence of increased serotonin levels that occur while taking the antidepressant. These symptoms are not technically the same thing as physical "withdrawal" from a drug. Physiological withdrawal happens when someone is taking a drug that can be addictive. This leads to craving and drug-seeking behavior. Antidepressants are not addictive or habit-forming. Unlike drug withdrawal, antidepressant discontinuation effects are not related to addiction but can reflect physiological consequences of stopping a drug, just as when someone with diabetes stops insulin. About one in five people who take an antidepressant for six or more weeks may experience discontinuation symptoms if they suddenly stop taking the medicine. Tapering down your medication gradually under the supervision of your health care provider can help avoid or minimize symptoms. However, it is still possible in those who decrease their dose too rapidly or sometimes even slowly quit the medicine.

Your doctor may diagnose you with antidepressant discontinuation symptoms if:

You suddenly develop symptoms days after stopping an antidepressant

Symptoms rapidly go away when you start taking the antidepressant again

What causes antidepressant discontinuation syndrome?

There's no way to predict if you will have discontinuation symptoms after quitting an antidepressant. Scientists are not exactly sure why some people develop antidepressant discontinuation syndrome while others do not.

Antidepressants help restore the normal function of naturally occurring, mood-regulating substances in the brain, called neurotransmitters, including serotonin and norepinephrine. Some mental health experts theorize that abruptly stopping an antidepressant simply does not give your brain time to adjust to the rapid changes.

Continued

Hardest-to-stop antidepressants

All depression drugs can potentially lead to discontinuation symptoms, but some are much more likely to do so than others. In fact, antidepressant labels often warn that stopping the medication too quickly may lead to bothersome symptoms. However, discontinuation symptoms are more likely with antidepressants that stay in your body for a shorter period of time, especially those that affect both serotonin and norepinephrine, such as duloxetine (cymbalta) and venlafaxine (effexor). Other short-acting medications that affect mainly serotonin include:

Withdrawal is less common with medications that take longer for the body to clear, such as fluoxetine (prozac) or vortioxetine (trintellix). However, longer-acting antidepressants can still sometimes cause discontinuation symptoms.

Discontinuation symptoms have also been reported in people who stop taking older types of antidepressant medications, including tricyclics and monoamine oxidase inhibitors (maois).

Symptoms of antidepressant discontinuation

Symptoms of antidepressant withdrawal depend on the specific medication you have been taking.

Symptoms most often occur within three days of stopping the antidepressant. Tthere can be some differences in how people feel when they stop their medicine. Some people might have symptoms that are moderate to severe and may last longer than a few weeks. Symptoms can include:

Anxiety

Depression and mood swings

Dizziness and balance problems, possibly vertigo

Electric shock sensations

Fatigue

Flu-like symptoms

Headache

Loss of coordination

Muscle spasms

Nausea

Nightmares

Tremors

Trouble sleeping

Vomiting

In rare cases, antidepressant withdrawal may cause mania. Certain, older types of antidepressants called maois can lead to confusion and psychotic symptoms.

How to stop antidepressants safely

If you are thinking about stopping your antidepressant therapy, talk to your doctor to discuss the risks and benefits of discontinuing treatment. Never stop "cold turkey." in many cases, the best way to stop taking most antidepressants is to slowly cut back your dose under the guidance of your doctor. This is called tapering. Tapering helps your brain adjust to the chemical changes and can help prevent discontinuation symptoms. Your doctor will tell you how to lower your dose over a couple of days. Never try to do this on your own.

Sometimes, doctors can prescribe medicines to help with discontinuation symptoms such as nausea or insomnia. They also may advise switching from a short- to a long-acting antidepressant to ease the transition off of a medicine for depression.

Discontinuation symptoms usually go away within a few weeks. But if you have extremely severe withdrawal symptoms, your doctor may recommend other medicines to relieve them.

Sources

American medical association web site: “american medical news: the long goodbye: the challenge of discontinuing antidepressants."

American family physician web site: "antidepressant discontinuation syndrome."

FDA web site: “understanding antidepressant medications.”

Marx, J. Rosen’s emergency medicine, 7th ed.

Shelton, R. The journal of clinical psychiatry, 2006.

Mayo clinic.Org web site: “symptoms from antidepressant withdrawal can be reduced by tapering.”

Haddad, P. Advances in psychiatric treatment, 2007.

Help guide.Org web site. “antidepressants: what you need to know about depression medications.”

Andrade, C. Journal of clinical psychiatry, july 2004.

Warner, C. American family physician, august 2006.

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