Graz 2013Graz 2013

The NADA Protocol and The NADA Protocol and Withdrawal Symptomes Withdrawal Symptomes from Benzodiazepinesfrom Benzodiazepines

15 years of Experience 15 years of Experience

Lars WiinbladLars Wiinblad

DenmarkDenmark

Benzodiazepines in DenmarkBenzodiazepines in Denmark

Recommendation from the Danish Recommendation from the Danish National Health Board since 1995: National Health Board since 1995:

2-4 weeks only. 2-4 weeks only. 50-80 % get addicted and suffer 50-80 % get addicted and suffer from severe withdrawal symptoms, from severe withdrawal symptoms, side effects and rebound.side effects and rebound.

Benzodiazepines are used by 8 % of Benzodiazepines are used by 8 % of the population.the population.

NADA 1997-2013NADA 1997-2013.. The use of benzodiazepines could be The use of benzodiazepines could be reduced. reduced.

The NADA-protocol made a difference.The NADA-protocol made a difference.

The protocol reduces most of the side-The protocol reduces most of the side-effects and withdrawal-symptoms associated effects and withdrawal-symptoms associated with Benzodiazepines.with Benzodiazepines.

NADA had a positive effect on sleep, NADA had a positive effect on sleep, anxiety, memory, aggression, restlesness, anxiety, memory, aggression, restlesness, stress, depression and relapse.stress, depression and relapse.

The use of anti-psychotic medicine did The use of anti-psychotic medicine did also decrease. also decrease.

Major sideeffects and withdrawal Major sideeffects and withdrawal symptomessymptomes

from benzodiazepinesfrom benzodiazepines

1.1. AnxietyAnxiety2.2. Sleep disordersSleep disorders3.3. Cognitive changesCognitive changes4.4. AddictionAddiction5.5. A number of psycological and fysical A number of psycological and fysical

problems problems (f. ex. aggression and (f. ex. aggression and

depression)depression)

Sygeplejersken maj 1996 (28)

Benzo-diazepin

escause anxiety

AnxietyAnxiety

80 % get anxiety as withdrawal symptoms.80 % get anxiety as withdrawal symptoms. Anxiety might appear after only 4 weeks.Anxiety might appear after only 4 weeks.

Anxiety increases during the medical Anxiety increases during the medical treatment.treatment.

50 % still suffer from anxiety after 50 % still suffer from anxiety after they have stopped taking the medicine they have stopped taking the medicine (months or years).(months or years).

Coffee makes the symptoms worse for 50 %Coffee makes the symptoms worse for 50 %

Sometimes the commercials tell the truth

Benzodiazepines and Sleep patternBenzodiazepines and Sleep pattern

Decrease REM and deep sleep:Decrease REM and deep sleep: Mood swings, anger, lack of concentration, pain, lact of energy etc.Mood swings, anger, lack of concentration, pain, lact of energy etc.

Tolerance after 3-10 days.Tolerance after 3-10 days. The medicine do not work after 4 weeks.The medicine do not work after 4 weeks.

Benzodiazepines have an major Benzodiazepines have an major impact on brain functionsimpact on brain functions

Oxazepam 15 mg 3 times a day

Inspiration from Bokholt, Inspiration from Bokholt, GermanyGermany

3 phase long term 3 phase long term program:program:

1.1.Get readyGet ready

2.2.Withdrawal Withdrawal symptomssymptoms

3.3.StabilisationStabilisation

The NADA-protocol makes the The NADA-protocol makes the differencedifference

Aftrapning af Benzodiazepiner under dække af øreakupunktur. 10 5 0

? uger

Withdrawal symptoms from benzodiazepines and

the use of the NADA protocol

Time

Symptoms

1. Get ready

Stabilisation for 2 weeks or more: •NADA-treatments twice a week (more is ok). •Sleep mix tea every day

Information NetworkingHealthy foodsExerciseStress management

Prepare the right strategy with the doctor

2. Withdrawal symptoms

• Acute phase: 3-5 treatments a week.• Treatment according to symptoms.• Sleep mix tea (5 cups or more each day).• Perhaps a few body points for some patients.

• Information (max. 5 minutes each time).• Support - Patience - Time.• Do not speed up the process. • Never increase the dose of medicine.

Aftrapning af Benzodiazepiner under dække af øreakupunktur. 10 5 0

? uger

Withdrawal symptoms from benzodiazepines and

the use of the NADA protocol

Time

Symptoms

Acute withdrawal symptomesAcute withdrawal symptomes

Axiety, panic and fobiaAxiety, panic and fobiaAggression and agitationAggression and agitationDepression Depression Sleeping disordersSleeping disordersMemory lossMemory lossLess kognitive abilityLess kognitive ability

20-25 % benefits from some body points 20-25 % benefits from some body points added 3 days after the medicine is reduced, added 3 days after the medicine is reduced, but only for a few days.but only for a few days.

GABA and Gb. 34

Gb. 34: Meeting point muscles and sinews.

GABA (A): Regulate sleep, anxiety and muscles.

GABA in Cerebro-spinal liquid increases significantly when needling Gb. 34.

Zhao Yanling, Zhang Wei et al; Chinese Acupuncture and Moxibusion. 1998 (9): 517-518

Aftrapning af Benzodiazepiner under dække af øreakupunktur. 10 5 0

? uger

Withdrawal symptoms from benzodiazepines and

the use of the NADA protocol

Time

Symptoms

3. Stabilisation

• NADA twice a week as long as needed.• Yin def. in Heart and Kidney seen in most patients.• Magnetic beads can be used in between the

NADA-treatments.

• Beware of drop out because of rebound.• 50% still have withdrawal symptomes after the

tablets are removed and need the NADA-protocol.• Theraphy can start slowly in this phase.

Long term withdrawal symptomesLong term withdrawal symptomes

Symptom Duration

Anxiety and stress Months – perhaps years. Peaks after six week.

Depression A few months.

Sleep disturbandes 6-12 months.

Cognitive functions Months to a year or more. Most patients recover, but not everyone…..

Strategy is importantStrategy is important

3 phase program:3 phase program:

1.1.Get readyGet ready

2.2.Withdrawal symptomsWithdrawal symptoms

3.3.Stabilisation – Start cognitive Stabilisation – Start cognitive or other therapy, or other therapy,

mindfulness etc.mindfulness etc.

25 %

25 %

The NADA-protocol makes the The NADA-protocol makes the program solid.program solid.

AlbertaAlberta

Schizophrenic, shelter, Schizophrenic, shelter, benzodiazepines, anxietybenzodiazepines, anxiety

NADA 2-3 times a weekNADA 2-3 times a weekSlowly step down the dose of medicineSlowly step down the dose of medicineMeditation (easy guide)Meditation (easy guide)

Started NADA trainingStarted NADA trainingTreating the other clientsTreating the other clientsMember of the NADA steering commiteeMember of the NADA steering commitee