Introduction: Benzodiazepine (BZD) dependence and withdrawal are significant public health concerns, affecting 15-30% of regular users within 4-6 weeks of administration. Rapid BZD tapering protocols in acute care settings can mitigate withdrawal symptoms and facilitate rehabilitation, yet are challenging due to variability in patient responses.
Case presentation: We report a case of a 67-year-old male with a history of high-dose BZD use for panic disorder and depression and recent mild ischemic stroke, presenting with worsening left lower limb paralysis. The patient's complex medication regimen included multiple BZDs and other psychotropic drugs. Given the risks associated with high-dose BZD use, particularly in the context of stroke rehabilitation, a rapid detoxification protocol was initiated, aiming to reduce BZD dosage by 25% every 4 days. This approach led to successful detoxification within 2 weeks without significant withdrawal symptoms, facilitating stroke rehabilitation and improving prognosis.
Discussion: This case highlights the effectiveness of a collaborative, rapid BZD tapering approach in an acute care setting, emphasizing the importance of patient cooperation, interdisciplinary communication, and careful monitoring of withdrawal symptoms. The case also underscores the potential benefits of replacing short-acting BZDs with long-acting ones, such as diazepam, to minimize withdrawal symptoms and support rehabilitation processes.
Conclusion: Rapid BZD detoxification is feasible and can be safely achieved within a short-term hospital stay, demonstrating significant benefits for patients with BZD dependence. This case contributes to the evolving strategies for managing BZD dependence in acute care settings, advocating for tailored, patient-centered approaches to detoxification.
