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August 16, 2006 3:32 AM

Enhancement of GABA's inhibitory activity caused by benzodiazepines.

Due to GABAs inhibitory activity caused by benzodiazepines, the brain's output of norepinephrine (noradrenaline), serotonin, acetyl choline and dopamine, is reduced. Is it possible that I'm experiencing a flood of these chemicals since I've begun to come off Clonazepam (Klonopin, Rivotril)?

posted by DZ-015 to Health & Fitness (5 answers total)

I am not sure if the mechanism is exactly as you describe, but a rebound of excitatory symptoms (insomnia, nervousness, tremors, even seizures) is certainly part of benzodiazepine withdrawal. Unfortuantely there is little consesus among experts as to which benzos produce the worst withdrawal symptoms and when a tapered withdrawal is most appropriate.
posted by TedW at 5:15 AM on August 16, 2006

Best answer: According to this source, it's possible:

On this model, withdrawal of the benzodiazepine once tolerance has developed would expose the recipient to all the drug-induced alterations in GABA receptors, now no longer opposed by the presence of the drug. The result would be underactivity in the many domains of central function normally modulated by GABA-ergic mechanisms. Since GABA is a universal inhibitor of neural activity and decreases the release of many excitatory neurotransmitters (acetylcholine, noradrenaline, dopamine, serotonin, glutamate)(46), there would be a surge of excitatory nervous activity. Increased release of dopamine, noradrenaline and serotonin has been demonstrated in certain areas of the rat brain during benzodiazepine withdrawal after chronic treatment(47,48). Such increases, coupled perhaps with "downstream" increases in sensitivity of excitatory receptors, may account for many benzodiazepine withdrawal symptoms. The various changes in GABA receptors occurring during tolerance may be slow to reverse after drug withdrawal and may do so at different rates(7), possibly accounting for the variable time of emergence and duration of individual withdrawal symptoms(1,18) and for the sometimes protracted nature of benzodiazepine withdrawal syndrome(1,2). For example, the protracted perceptual and muscular disturbances described above raise the possibility that benzodiazepines are capable of inducing long-term hyperexcitability in central sensory and motor neural pathways.

posted by justkevin at 6:39 AM on August 16, 2006 [1 favorite]

Yes, it's possible. If you were on them for any length of time, you should taper off the dose.
posted by Mr. Gunn at 2:42 PM on August 16, 2006

Benzo withdrawal is an unpleasant experience, and there's really no way to avoid the unpleasantness. Tapering is definitely important, but the worst symptoms are backloaded, and you just have to live through them. After your last dose, the next week or so won't be fun.

But it doesn't last forever.
posted by Steven C. Den Beste at 7:01 PM on August 16, 2006

Response by poster: Thanks. I'm going to see my doctor today. No-one told me I would develop a physical dependence on Clonazepam!
posted by DZ-015 at 4:16 AM on August 17, 2006