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Phytotherapy aids in benzodiazepine withdrawal

.Based on previous research and the author's own experience treating more than 500 patients at a medical detoxification unit in Auckland, New Zealand, this well-referenced paper discusses the use of herbs in the management of benzodiazepine withdrawal symptoms. Withdrawal symptoms related to the benzodiazepine class of anxiolytic drugs (such as Valium®) are generally long-lasting and most often include anxiety, insomnia and irritability. Dizziness, headache, tinnitus, tremor, loss of appetite, gastrointestinal upset, and perceptual disturbances are also common.

Many patients present at this clinic with a "polydrug" history of substance abuse, including combination drug and alcohol addictions. The therapeutic strategy used at the clinic is intended to help alleviate acute withdrawal symptoms while providing supportive treatment for underlying problems such as anxiety, depression and panic attacks. Most clients receive concomitant treatment with conventional medications. However, according to the author, "in a significant number of cases the need for additional ameliorative orthodox medication (especially diazepam and methadone) is avoided through the introduction of phytotherapy, often after consultation between the phytotherapist and medical practitioner." Although the paper does not provide long-term follow-up data, the author considers botanicals particularly useful in helping to safely reduce the anxiety and overall nervous system weakness often associated with recovery from benzodiazepine abuse. He states that "relatively large doses of appropriate phytomedicines are often required to produce a significant effect in alleviating acute withdrawal symptoms in [drug] tolerant individuals."

The author, a phytotherapist and pharmacist, mentions 28 plants that are effectively used by the clinic for anxiolytic, sedative, muscle relaxant, antidepressant, and/or adaptogenic effects. Seven are singled out for detailed discussion: valerian (Valeriana officinalis L. Valerianaceae), kava (Piper methysticum G. Forster, Piperaceae), passionflower (Passiflora incarnata L. Passifloraceae), manuka (Leptospermum scoparium Forster & Forster f. Myrtaceae), St. John's wort (Hypericum perforatum L. Clusiaceae), ashwaganda (Withania somnifera (L.) Dunal, Solanaceae), and schisandra (Schisandra chinensis (Turcz.) Baillon, Schisandraceae).

Part of the author's rationale for using these plants is that some of them contain constituents shown to act as agonists at the central benzodiazepine receptors in a manner similar to the drugs themselves. Kava, Passiflora incarnata and P. coerulea, ashwaganda, Matricaria recutita L. Asteraceae, Scutellaria baiacalensis L. Lamiaceae, and manuka (a native New Zealand plant) are among the plants cited as having demonstrated benzodiazepine receptor agonist actions.

Part II of this article will deal with the use of herbs in alleviating symptoms of opiate drug withdrawal. -- Evelyn Leigh, HRF

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[Rasmussen, P. 1997. A role for phytotherapy in the treatment of benzodiazepine and opiate drug withdrawal (Part 1). The European Journal of Herbal Medicine, Vol. 3, No. 1, 11-21.]

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