Anxiety, insomnia, irritability, tremulousness, gastrointestinal disturbances and dysphoria occur much as in the withdrawal of any tranquilliser or sedative drug. Other symptoms appear to be more specific. Perceptual distortions occur in all modalities. Sounds may be unduly loud and patients may hear non-existent thumps or tunes. Sights are distorted and may be misinterpreted, with occasional brief visual hallucinations.
Paraesthesia is common, as are distortions of smell and taste.
Paranoid thoughts and feelings occur frequently. Pain and stiffness in various parts of the body, especially the face, are common, with muscular spasms which may appear as myoclonic jerks, or as local tremors and fasciculation. What makes withdrawal so bad, apart from the perceptual disturbances which make patients feel they are going mad, is that it goes on for so long. Ashtons study suggests that many symptoms, though improved by four weeks, may continue intermittently for months. There is a period of a few days to a few months during which the benzodiazepine drug has an active effect.