Areas › Worry and anxiety › Treatment and medication
Physical dependence on a sedative can build while you are taking it exactly as prescribed. Nothing has gone wrong with you and nobody has misused anything.
Regulators strengthened the warnings across this whole class of medicines to say so plainly, including that withdrawal can be drawn out. Knowing it in advance changes what you do with it: you plan the ending at the beginning, and you treat a hard fortnight after stopping as expected rather than as proof you still need it. If someone has been carrying quiet shame about this, hearing that it is ordinary is worth a great deal.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
No blame will be attached to the blind, the lame, the sick (Quran 24:61). Being ill and needing an accommodation is treated as unremarkable, and so is a body that has adapted to a medicine.
لَّيۡسَ عَلَى ٱلۡأَعۡمَىٰ حَرَجࣱ وَلَا عَلَى ٱلۡأَعۡرَجِ حَرَجࣱ وَلَا عَلَى ٱلۡمَرِيضِ حَرَجࣱ وَلَا عَلَىٰٓ أَنفُسِكُمۡ أَن تَأۡكُلُواْ مِنۢ بُيُوتِكُمۡ أَوۡ بُيُوتِ ءَابَآئِكُمۡ أَوۡ بُيُوتِ أُمَّهَٰتِكُمۡ أَوۡ بُيُوتِ إِخۡوَٰنِكُمۡ أَوۡ بُيُوتِ أَخَوَٰتِكُمۡ أَوۡ بُيُوتِ أَعۡمَٰمِكُمۡ أَوۡ بُيُوتِ عَمَّٰتِكُمۡ أَوۡ بُيُوتِ أَخۡوَٰلِكُمۡ أَوۡ بُيُوتِ خَٰلَٰتِكُمۡ أَوۡ مَا مَلَكۡتُم مَّفَاتِحَهُۥٓ أَوۡ صَدِيقِكُمۡۚ لَيۡسَ عَلَيۡكُمۡ جُنَاحٌ أَن تَأۡكُلُواْ جَمِيعًا أَوۡ أَشۡتَاتࣰ اۚ فَإِذَا دَخَلۡتُم بُيُوتࣰ ا فَسَلِّمُواْ عَلَىٰٓ أَنفُسِكُمۡ تَحِيَّةࣰ مِّنۡ عِندِ ٱللَّهِ مُبَٰرَكَةࣰ طَيِّبَةࣰۚ كَذَٰلِكَ يُبَيِّنُ ٱللَّهُ لَكُمُ ٱلۡأٓيَٰتِ لَعَلَّكُمۡ تَعۡقِلُونَ
No blame will be attached to the blind, the lame, the sick.Whether you eat in your own houses, or those of your fathers, your mothers, your brothers, your sisters, your paternal uncles, your paternal aunts, your maternal uncles, your maternal aunts, houses you have the keys for, or any of your friends’ houses, you will not be blamed: you will not be blamed whether you eat in company or separately. When you enter any house, greet one another with a greeting of blessing and goodness as enjoined by God. This is how God makes His messages clear to you so that you may understand
Qur’an 24:61read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
The closest careful evidence comes from antidepressants rather than sedatives. People who stopped one after it had worked relapsed considerably more often than those who kept taking it, which argues for stopping slowly and with a plan instead of the moment things feel better. That is a different class of drug, so treat it as a lesson about endings deserving as much thought as beginnings.
Batelaan NM, Bosman RC, Muntingh A, Scholten WD, Huijbregts KM, van Balkom AJLM. (2017). Risk of relapse after antidepressant discontinuation in anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder: systematic review and meta-analysis of relapse prevention trials.. BMJ (Clinical research ed.) doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
A body adjusting to a regular dose is a normal process, not a sign of weakness.
When not to
Never stop a sedative abruptly on your own, since sudden withdrawal from this class can be dangerous.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
The gentler alternatives are for avoiding a habit forming medicine in the first place. They cannot carry someone who is already dependent, and offering one as a straight swap mid crisis sets everybody up to fail.
Before choosing what to try, work out which kind of anxiety you are dealing with. What settles a sudden surge and what wears down months of low grade worry are rarely the same thing.
Saying that you do not know, and then showing where you would look, beats an answer improvised on the spot. It also teaches the person asking how to check things for themselves.