title: [Two cases of psychotic state following normal-dose benzodiazepine withdrawal].
abstract: We report two cases of severe withdrawal symptoms after abrupt discontinuation of a long-term normal-dose benzodiazepines (BZD) administration. Case 1, a 61-year-old man, suffered from delirium on the 7th day after abrupt discontinuation of nitrazepam, 10 mg/day. Case 2, a 49-year-old woman, suffered from auditory hallucination on the 4th day and visual cognitive disorder on the 5th day after abrupt discontinuation of nitrazepam, 5 mg/day, and triazolam, 0.5 mg/day. A withdrawal syndrome after discontinuation of normal-dose BZD is uncommon, and a psychotic withdrawal reaction is even more uncommon. We show how a continuous administration of BZD for a period of longer than 6 months and the presence of severe insomnia are risk factors predictive of a psychotic reaction. We also explain the predictive method used to determine the onset time of such a severe state. In the case of a psychotic state, we recommend intravenous diazepam injection. To prevent withdrawal reaction, we also recommend a gradual reduction after administration of normal-dose BZD.
mesh_terms: D014151:Anti-Anxiety Agents / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009567:Nitrazepam / Q000009:adverse effects; D010468:Perceptual Disorders / Q000139:chemically induced*; D013375:Substance Withdrawal Syndrome; D014229:Triazolam / Q000009:adverse effects
chemical_list: D014151:Anti-Anxiety Agents; D014229:Triazolam; D009567:Nitrazepam