A drug-resistant recurrence of the primary illness or a persistent withdrawal syndrome? “Mirror” symptoms in patients in long-term treatment with benzodiazepines

Purpose: In benzodiazepine (BZD) iatrogenic addiction, doses often run behind the growing level of the patient’s need. This creates experience of deficiency (withdrawal) symptoms, despite continued drug intake. As mirror reflections (negatives) of all the therapeutic actions of the drug, they mimic the original ailment, with extra symptoms. Despite observed resistance to standard treatment and responsiveness exclusively to BZD, these may be misinterpreted as a genuine malady, which dooms the outcome. Such mistakes need to be prevented. Case description: Two patients who began taking BZD to treat anxiety (female) and stress (male), over time became disability pensioners for “drug-resistant” anxiety disorders and “drug-resistant” somatic complaints. These ineffective treatments lasted until the dependence scenario was recognised. Proper treatment (detoxification) eliminated symptoms or made them responsive to standard treatment. Comment: Treating the “mirror” symptoms as a drug-resistant, genuine malady (or new diseases) worsens the patient’s condition and prognosis. Proper identification of the origin of a growing set of symptoms may result in a spectacular improvement.