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Withdrawal and Aggression

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Withdrawing from nearly any substance can result in behavioral changes. Along with a wide array of other withdrawal symptoms, many people will act out aggressively as their body is adjusting to changes without drugs or alcohol. With strong cravings, aches and pains, many people will lash out at their loved ones or care takers showing signs of aggression due to post-acute withdrawal syndrome.

What is Post-acute Withdrawal Syndrome?

Post-acute withdrawal syndrome is described as a set of persistent impairments that occur after withdrawal from alcohol, opiates, benzodiazepines, antidepressants and other substances. This syndrome affects the individual through many aspects of recovery and their everyday life, making it difficult to keep a job and interact with family and friends as they once would.  Approximately 90% of people withdrawing from opioid drugs will experience post-acute withdrawal syndrome and 75% for people withdrawing from alcohol, methamphetamine, or benzodiazepines and other psychotropic drugs.

Symptoms of Post-acute Withdrawal Syndrome

Post-acute withdrawal syndrome can last from a year to several decades, or indefinitely, with the symptoms entering into periods of relative remission between periods of instability. Symptoms often  include:

  • mood swings
  • agressive behavior
  • anhedonia (the inability to feel pleasure from anything beyond use of the drug)
  • insomnia
  • drug craving and obsession
  • anxiety
  • panic attacks
  • depression
  • suicidal ideation
  • suicide
  • cognitive impairment


In time post-acute withdrawal syndrome symptoms will fade, however it can take six months to several years in more severe cases. Pharmaceutical and behavioral therapy are often needed to help people deal with the symptoms of this withdrawal period, allowing them to lead normal lives.

Flumazenil is often used in patients who are recovering from Benzodiazepine dependency, this medication helps to reduce feelings of hostility and aggression. Patients recovering from alcohol dependency can find relief from post-acute withdrawal symptoms with the aid of the medication Acamprosate. Other medications such as carbamazepine or trazodone, have been shown to be affective in the treatment of post-acute withdrawal syndrome.

Cognitive behavioral therapy can also be beneficial in the treatment of the post acute withdrawal syndrome especially when the patient suffers extreme cravings. The combination of pharmaceutical and behavioral therapy has been effective in treatment many people recovering from dependency to alcohol, opiates, benzodiazepines, antidepressants and other substances.

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