Benzodiazepine Scoping Review Identifies Signals of Protracted Withdrawal

August 28, 2025 – A brand new study, Long-term neurological consequences following benzodiazepine exposure: A scoping review, was published today in the journal PLOS ONE. It is the result of 2 ½ years of work and the largest review of its type to date.

In 2024, a PLOS ONE study (aka "The BIND Paper") introduced the term “Benzodiazepine Induced Neurological Dysfunction (BIND),” and showed that this injury exists in a sub-population of individuals.

To better characterize the likelihood of developing BIND, a team of researchers retrieved 14,097 publications, of which 11,446 were screened. After a thorough assessment, the researchers identified 46 eligible studies.

Link to the Article:

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0330277

Initial Findings

In the 46 eligible studies, researchers found that some studies showed benefit from benzodiazepine discontinuation and nearly all of the studies identified an acute phase of withdrawal. That being said, they also found evidence of persistent neurological dysfunction. In fact, 61% of the studies provided signals that suggest a protracted withdrawal phase, although protracted withdrawal did not affect all persons

Long-term neurological consequences following benzodiazepine exposure: A scoping review. Fig. 3.

The core findings from each of the eligible studies is provided in three separate tables: those which provided notable signals of protracted symptoms (61%), those that showed benefits from discontinuation (30%), and studies which demonstrated no notable results (9%).

While many patients benefit from discontinuation, others face persistent and sometimes disabling symptoms months or years later. Unfortunately, “few benzodiazepine studies looked for prolonged symptoms.” These symptoms appear “unpredictably and only in a subpopulation of patients,” and they were not systematically studied.

Benzodiazepines are powerful agents, the use of which may lead to long-term neurologic dysfunction in some patients. The patient’s susceptibility, the extent, and reversibility of these neurologic changes is not known. There is an urgent need to answer those questions and limit long-term benzodiazepine use in accordance with the Hippocratic oath: first, do no harm.

— Scoping Review, Discussion

About the Research Team

The "BZD Research Team" sponsored by the Alliance for Benzodiazepine Best Practices has been working together on various projects since 2020, when it began by publishing three consecutive papers on the Benzodiazepine Survey of 2018/2019.

The third paper in that series was the BIND Paper, officially titled "Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey." It changed the landscape for how protracted benzodiazepine withdrawal is identified, and treated, and much of that work informed the research on this paper. In fact, five of the authors on that paper (Ritvo, Foster, Finlayson, Silvernail, and Martin) are still team members and authors on this scoping review.

Scoping Review authors and their affiliations:

• University of Colorado School of Medicine

  • Christi Piper

  • Alexis D. Ritvo

  • Kyla N. Shade

• Vanderbilt University Medical Center

  • A. J. Reid Finlayson

  • Peter R. Martin

• The School of Public Health at Yale University

  • Jolene E. Bressi

  • Ian J. Martin

• The Alliance for Benzodiazepine Best Practices

  • Bernard Silvernail

• Uneven Life

  • D E Foster

Remembering Christy

Unfortunately, during the work on this project, our research team suffered a huge loss.

Dr. Christy Huff was the heart of the BZD Research Team. In addition to being the co-creator of the Benzo Survey of 2018/2019, lead author on its second paper, and a long time member of our team, she also was one of the first to conceive and help formulate the protocol for this scoping review. "Her work on behalf of benzodiazepine safety is well known, deserves praise, and will benefit many patients in years to come."

Unfortunately, Dr. Huff passed away on March 5, 2024, due to complications from BIND. The team regrets that she can't be listed as one of its authors, but acknowledges that none of this would have been possible without her.

"She was an uncompromising patient advocate, but, to us, she was also a dear friend and beloved colleague."

— Scoping Review, Acknowledgments

I had the pleasure of working with Christy in a variety of settings for about seven years, and she was a close friend. In her role as Medical Director for Benzodiazepine Information Coalition, in her research, and in her outreach to those suffering from benzodiazepine dependence and withdrawal, Christy never let you forget that she was a caring doctor, friend, and colleague.

We miss her dearly.

References

• Huff C, Finlayson AJR, Foster DE, Martin PR. "Enduring neurological sequelae of benzodiazepine use: an Internet survey." Therapeutic Advances in Psychopharmacology. 2023;13. doi:10.1177/20451253221145561. https://journals.sagepub.com/doi/10.1177/20451253221145561.

• Reid Finlayson AJ, Macoubrie J, Huff C, Foster DE, Martin PR. "Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey." Therapeutic Advances in Psychopharmacology. 2022;12. doi:10.1177/20451253221082386. https://journals.sagepub.com/doi/full/10.1177/20451253221082386. 

• Ritvo AD, Foster DE, Huff C, Finlayson AJR, Silvernail B, et al. (2023) "Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey." PLOS ONE 18(6): e0285584. https://doi.org/10.1371/journal.pone.0285584.

• Shade KN, Ritvo AD, Silvernail B, Finlayson AJR, Bressi JE, Foster DE, Martin IJ, Piper C, Martin PR. (2025) Long-term neurological consequences following benzodiazepine exposure: A scoping review. PLOS ONE 20(8): e0330277. https://doi.org/10.1371/journal.pone.0330277.