Abrupt withdrawal from therapeutically administered diazepam. Report of a case

Subjective, behavioral, and physiologic changes followed abrupt withdrawal of diazepam (Valium) in a patient who had been treated with 30 to 45 mg of diazepam daily for 20 months. Precipitous weight loss and orthostatic pulse rate increase were a part of the abstinence syndrome, which occurred between the fifth and ninth days of withdrawal. Accompanying these changes in physiologic measures were discomforting symptoms and dysphoria that were aversive and reinforcing to drug taking since the patient sought diazepam administration. These observations suggest that changes in mood, feeling states, and behavior may be the most prominent characteristics of the abstinence syndrome associated with physical dependence on this dose level of diazepam.