Do Whole Foods Help During a Benzodiazepine Taper? What Food Can and Cannot Do

Do whole foods help during a benzodiazepine taper?

Yes, in a modest way. Whole foods are foods that reach the plate close to the way they grew: vegetables, fruit, beans, whole grains, eggs, fish, meat, nuts, and seeds. Eaten at regular times, they keep the body steadily fed through a taper that lasts months.

They do not treat withdrawal. No food makes up for a dose reduction that was too large, and no diet shortens a taper.

So, why write about food at all? A long taper is easier on a person who is fed, rested, and not living on coffee. And, much of the diet advice written for people coming off a benzodiazepine starts from a mistaken idea about gamma-aminobutyric acid (GABA), the brain’s main calming chemical.

Withdrawal is not a shortage of GABA.

A common explanation is that after long-term use the brain can no longer make enough GABA. From there it is a short step to lists of foods said to rebuild it. That is not what happens. The brain keeps making GABA.

In the first chapter of the Ashton Manual, Professor C. Heather Ashton explains that a benzodiazepine attaches to its own site on the GABA receptor and boosts the effect of the GABA already there. Over months of daily use, the nervous system compensates. The receptors become less responsive, so GABA and the medication both have less effect.

When the dose falls, those less responsive receptors are left with less help, and the nervous system runs fast until they readjust. That takes time. Nothing has run out, so there is nothing for a food to replace, and whether a GABA supplement helps is a separate question with limited evidence behind it.

This adaptation is called physical dependence, and it happens to people who took their medication exactly as prescribed. Physical dependence is not addiction.

So, a person tapering a prescribed medication has no need for the cleanses and purifying diets sold to people who want a drug out of their system. There is no toxin to flush out. There are receptors that need time.

Why do regular meals matter when a taper lasts months?

A taper guided by the Ashton Manual or the Maudsley Deprescribing Guidelines is measured in months, and sometimes in more than a year. Over that stretch, appetite comes and goes. Patients often describe nausea, a tight stomach, or days when food holds no interest.

Skipped meals bring sensations of their own. A person who has not eaten since morning can feel shaky, lightheaded, and irritable, with a pounding heart, and those feelings are hard to tell apart from a wave of withdrawal. Regular meals remove one source of them.

In Chapter III of the Manual, Professor Ashton describes a normal healthy diet as one with generous amounts of fruit and vegetables, a source of protein and fats, and not too much pure sugar or junk food. That is a fair description of whole foods. She also observes that overly restrictive diets can have adverse effects.

Fluids follow the same rule. Going short on water can add lightheadedness and a headache to a day that already has enough of both. Ordinary drinking through the day is enough, and Professor Ashton writes that there is no need to drink extra in order to flush out toxins.

The evidence that meal timing or food quality changes withdrawal itself is limited. A long taper is like a long walk with a heavy pack. Good food does not shorten the trail. Yet, nobody walks it well on coffee and candy.

What about caffeine, sugar, and alcohol?

Caffeine is a stimulant, and a nervous system in withdrawal is already running fast. Yet, the Manual does not call for a ban. In Chapter III, Professor Ashton writes that coffee or tea in moderation, about two cups a day, is compatible with withdrawal for most people.

She makes exceptions for people who are very sensitive to caffeine and for those with very high anxiety, and she advises against caffeine late in the evening. So, a person who notices jitters, palpitations, or worse sleep after coffee has good reason to cut back. Cutting back gradually is kinder, because caffeine has a withdrawal headache of its own.

Sugar calls for the same moderation. Many people find that a large amount of sugar on an empty stomach is followed, an hour or two later, by a slump that feels shaky and anxious. Meals built on protein, vegetables, and whole grains digest more slowly and bring fewer of those swings.

The evidence here is limited too. The point is only that fewer swings leave fewer sensations to mistake for withdrawal.

Alcohol is different. It acts on the same GABA receptors as a benzodiazepine, so it is best avoided during a taper. A drink may seem to calm the evening, and then it can unsettle the taper and worsen symptoms afterward. In the same chapter, Professor Ashton warns against substituting alcohol for a falling dose of benzodiazepine.

Do magnesium, B vitamins, and omega-3 fats from food make a difference?

Magnesium is found in leafy greens, beans, nuts, seeds, and whole grains. B vitamins come from eggs, fish, meat, dairy, beans, and greens, and omega-3 fats from salmon, sardines, mackerel, walnuts, and flaxseed.

The body needs all three, and a varied diet of whole foods supplies them. That is general nutrition. The evidence that any of them eases benzodiazepine withdrawal is limited, and lists that assign one food to anxiety, another to insomnia, and a third to headaches promise more than anyone can support.

Supplements are a different matter from food. Professor Ashton writes that there is no general need for dietary supplements or extra vitamins and minerals during withdrawal, and that all of them can be harmful in excess. The patient community is cautious about magnesium, B vitamins, and vitamin D in supplement form. Those cautions have merit, yet they are not universal, because individual response varies.

Dr. Mark Leeds, an osteopathic physician and deprescribing specialist in Fort Lauderdale, Florida, treats supplement questions as individual decisions. Some supplements cause trouble during withdrawal and some help, so each one is weighed for the particular patient, with the pharmacology in mind. None of them takes the place of a gradual taper.

What if the stomach will not cooperate?

Unfortunately, the gut is often part of withdrawal. Bloating, nausea, cramping, constipation, and loose stools are common enough that patients have a name for the cluster, benzo belly. It can look a great deal like irritable bowel syndrome.

Professor Ashton covers digestive problems in Chapter III. She notes that medical tests usually find no abnormality, and that some people stop tolerating certain foods, which is usually not a true allergy. Most digestive symptoms get better after withdrawal, although in a few people they linger.

So, when a food seems to cause trouble, setting it aside for a while is reasonable. Cutting out whole food groups is another matter, since a narrow diet is hard to live on for months. Smaller, plainer meals are often easier than large ones, and a companion article covers benzo belly and what to eat while tapering.

Digestive symptoms that are severe, new, or persistent deserve a medical evaluation of their own. Withdrawal is the usual explanation during a taper, yet it does not rule out an unrelated problem.

Fortunately, what eases withdrawal is the taper itself.

How a person feels during a taper depends mostly on the size and the pace of the dose reductions. In Chapter II, Professor Ashton proposes steps of up to one tenth of the dose, with the pace set by the person tapering, and a crossover to diazepam where a longer-acting medication helps.

The Maudsley Deprescribing Guidelines add the hyperbolic shape, in which each reduction is sized to the dose that remains. The steps get smaller as the dose gets lower. A taper of this kind takes months, and sometimes longer.

When symptoms flare after a reduction, the answer is a change of pace planned with the prescriber: a short hold and a smaller next step for some patients, a steady pace for others, because everybody is different. A new diet is not the answer, and neither is stopping. When the United States Food and Drug Administration (FDA) updated the boxed warning on benzodiazepines in 2020, it stated that stopping abruptly or reducing the dose too quickly can result in withdrawal reactions, including seizures, which can be life-threatening. For a seizure or any other medical emergency, call 911.

The receptors do readjust, and they do it on their own schedule. In the meantime, regular meals of plain food are one of the few parts of the day a person in withdrawal can keep steady. That is worth having.

Dr. Leeds’ practice in Fort Lauderdale is a concierge practice, not an insurance practice, and its primary service is medically supervised benzodiazepine and z-drug tapering for patients in Florida. Each taper is gradual, directed by the patient, and slowed when symptoms show the pace is too fast. Questions about food and supplements are answered patient by patient along the way. Contact the office to discuss a supervised taper.

This article is educational. It is not medical advice, and reading it does not create a doctor-patient relationship. Decisions about starting, continuing, or tapering any medication should be made with your own physician.