Benzodiazepines–often called “benzos”–are depressants that produce sedation and hypnosis, relieve anxiety and muscle spasms, and reduce seizures. The most common benzodiazepines are Valium®, Xanax®, Halcion®, Ativan®, and Klonopin®. Unfortunately, such drugs can present special challenges for people with Lyme disease.

By Jennifer Leigh, PhD.

I work with clients who were put on a benzodiazepine to cope with their Lyme disease symptoms. This blog post is for them and their healthcare providers.

Lyme disease and benzodiazepine withdrawal (BWD) are two medical conditions that can significantly impact an individual’s health. While the two may seem unrelated, recent research has shown a potential connection between the two.

Unfortunately, many medical professionals are uneducated about the dangers and damages of benzodiazepines and prescribe them to Lyme patients. They don’t know that the benzodiazepine may worsen Lyme symptoms or create new uncomfortable and frightening symptoms.

To add to the confusion, symptoms of Lyme and benzodiazepine often mimic one another, causing the Lyme/BWD sufferer anguish and confusion about what is happening in their bodies. Let’s explore the connection between Lyme disease and benzodiazepine withdrawal.

Lyme disease

Lyme disease, a tick-borne illness, is caused by the bacterium Borrelia burgdorferi. This disease manifests through many symptoms, such as insomnia, fatigue, fever, and joint pain. The inflammation induced by the bacterium can potentially interfere with the production and function of neurotransmitters in the brain, which regulate mood and emotions. Consequently, individuals may experience anxiety, depression, and irritability.

Moreover, the chronic nature of Lyme disease and its effect on daily living can exacerbate feelings of anxiety and stress. Doctors may prescribe a benzodiazepine for anxiety and insomnia, putting a Lyme sufferer at more risk for more ill health and a prolonged recovery.

Benzodiazepines

Benzodiazepines are psychoactive medications often prescribed for anxiety, insomnia, and seizure disorders. Benzodiazepines act by binding to gamma-aminobutyric acid (GABA ) receptors, the primary inhibitory neurotransmitter in the central nervous system. GABA helps reduce neuronal excitability, promoting relaxation and calmness.

However, this action can downregulate GABA receptors, resulting in decreased number and sensitivity of GABA receptors and diminished inhibitory effects. (This is called tolerance.) The lack of inhibitory ability causes the nervous system to become hyperexcited, leading to anxiety, panic, pain, fatigue, insomnia, and various physical and emotional symptoms.

Even short-term or occasional use of benzodiazepines can contribute to downregulating GABA receptors. When one lowers the dose or stops taking their benzodiazepine (do not stop abruptly!), intense withdrawal symptoms can occur. Benzodiazepine withdrawal occurs due to chemical dependency on the drug and is not an addiction.

It is important to note that tolerance and withdrawal symptoms can resemble Lyme disease symptoms.

Withdrawal from benzodiazepines

Withdrawal from benzodiazepines can be challenging and may result in protracted symptoms that last for months or even years. (In September 2020, the FDA black-boxed benzodiazepines, including a warning about dependency and withdrawal.)

Benzodiazepine withdrawal symptoms can include heightened anxiety, panic, terror, insomnia, irritability, muscle tension, pain, disequilibrium, depersonalization and derealization, cognitive impairments, memory loss, and other disabling symptoms.

In severe cases, withdrawal may lead to seizures or other life-threatening complications. The prolonged nature of these withdrawal symptoms can significantly impact an individual’s quality of life, affecting personal relationships, work performance, and overall well-being.

Effects of benzodiazepine withdrawal and Lyme disease

Recent studies have shown that patients with Lyme disease who are in tolerance (have become chemically dependent) to their benzodiazepine or going through withdrawal from tapering or cessation of the drug may experience more severe and prolonged withdrawal symptoms than those without Lyme disease.

This could be because Lyme disease can impact the functioning of the central nervous system, which can also be affected by benzodiazepine withdrawal.

A study published in the Journal of Addiction Medicine in 2018 found that patients with Lyme disease who were undergoing benzodiazepine withdrawal had a higher rate of insomnia, anxiety, and other withdrawal symptoms than those without Lyme disease.

Additionally, the study found that these symptoms persisted for longer in patients with Lyme disease, even after the benzodiazepine had been eliminated from their system (Hassett et al., 2018).

Blood pressure

Lyme disease and benzodiazepine withdrawal can significantly affect blood pressure, and their combined impact may exacerbate the severity of these effects. A study published in the journal Psychopharmacology in 2019 found that patients with Lyme disease who were undergoing benzodiazepine withdrawal had higher cytokine levels in their blood than those without Lyme disease.

Cytokines are proteins produced by the immune system in response to infection or inflammation, and high levels have been linked to increased severity of withdrawal symptoms (Zelová et al., 2018). Specific cytokines, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and interleukin-1 beta (IL-1 beta), can cause inflammation in blood vessels and impair their ability to dilate. This leads to increased resistance to blood flow and a subsequent rise in blood pressure.

Furthermore, cytokines can stimulate the production of stress hormones such as cortisol and elevate blood pressure. Benzodiazepine use decreases GABA activity, triggering a surge in neurotransmitters like norepinephrine and adrenaline. These neurotransmitters can cause sudden increases in blood pressure, manifesting as headaches, dizziness, and potentially dangerous complications.

Lyme disease and benzodiazepine withdrawal can independently affect blood pressure, and their combined influence may worsen the impact on an individual’s blood pressure regulation. This highlights the importance of carefully monitoring and managing blood pressure for patients experiencing both conditions.

Additional support

While more research is needed to understand the connection between Lyme disease and benzodiazepine withdrawal fully, these studies suggest that patients with Lyme disease may require additional support and monitoring during benzodiazepine withdrawal to manage their symptoms effectively.

Additionally, healthcare providers should know the potential for more severe and prolonged withdrawal symptoms in these patients and take appropriate steps to manage their care accordingly.

Withdrawal

Dealing with Lyme disease symptoms and benzodiazepine withdrawal can be challenging, but managing them with the right strategies and support is possible. Here are some tips to help you cope with the concurrent symptoms of these conditions:

1. Seek professional medical help: If you are experiencing symptoms of Lyme disease and benzodiazepine withdrawal, it is essential to seek professional medical help. A benzo-wise healthcare professional can help you plan an appropriate taper off your benzodiazepine.
2. Practice self-care: Self-care is crucial when dealing with Lyme disease symptoms and benzodiazepine withdrawal. Getting enough rest, eating a healthy diet, and staying hydrated can help support your body’s natural healing processes. Engaging in activities that promote relaxation, such as meditation or yoga, can also be helpful.
3. Stay connected: It is essential to stay connected with friends and family during this time. A support system can help reduce feelings of isolation and provide emotional support when dealing with challenging symptoms. Consider joining a support group or connecting with others who have gone through similar experiences. You may want to consider joining Heal With Dr. Jenn, a benzodiazepine withdrawal support group.
4. Address symptoms individually: The symptoms of Lyme disease and benzodiazepine withdrawal can be challenging to manage, but addressing them individually can be helpful. Remember that adjunct medications can often worsen symptoms or slow healing. Some medications can have their withdrawal syndrome.
5. Stay informed: Learning more about Lyme disease and benzodiazepine withdrawal can help you understand your symptoms and feel more empowered in managing them. Stay informed by reading reliable sources of information, such as medical journals or websites from reputable organizations.
6. Practice patience: Recovery from both Lyme disease and benzodiazepine withdrawal can take time, so it is essential to be patient with yourself. It can be frustrating to experience symptoms that impact your daily life, but know that it is possible to manage them and that you will feel better with time.

In conclusion, coping with the concurrent symptoms of Lyme disease and benzodiazepine withdrawal can be challenging, but with the right strategies and support, it is possible to manage them effectively. Seeking professional medical help, practicing self-care, staying connected, addressing symptoms individually, staying informed, and practicing patience can help manage these conditions. Remember to be patient with yourself and trust that with time, you will feel better.

Jennifer Leigh has a doctorate in psychology and specializes in the field of benzo withdrawal/BIND (benzodiazepine-induced neurological dysfunction). In addition to directly helping patients, she also offers a six-week certification course for providers called Understanding Benzodiazepine Withdrawal/BIND for Healthcare Professionals.