Word Net
withdrawalNoun
1 a retraction of a previously held position
[syn: backdown,
climb-down]
2 the act of taking out money or other
capital
3 the act of withdrawing
4 avoiding emotional involvement [syn: detachment]
5 formal separation from an alliance or
federation [syn: secession]
6 the termination of drug taking [syn: drug
withdrawal]
Moby Thesaurus
Jim Crow, abandonment, abdication, abjuration, abjurement, abolishment, abolition, abrogation, absentation, abstraction, abulia, agreement to disagree, alienation, aloneness, aloofness, anesthesia, annulment, anxiety, anxiety equivalent, anxiety state, apartheid, apartness, apathy, apostasy, autism, autistic thinking, avoidance mechanism, avulsion, backwardness, bashfulness, blame-shifting, blankness, boredom, cancel, canceling, cancellation, carelessness, cassation, casting away, catatonia, catatonic stupor, celibacy, cessation, chill, chilliness, clearance, cold blood, cold heart, coldheartedness, coldness, compensation, compulsion, constraint, coolness, counter-culture, countermand, counterorder, cutting out, deadpan, decampment, decompensation, defeasance, defense mechanism, dejection, demission, denial, departure, deportation, deposal, depression, deracination, dereism, dereistic thinking, desuetude, detachment, difference, disaccord, disagreement, disapprobation, disapproval, disarticulation, disassociation, disavowal, discard, disclaimer, disclamation, disconnectedness, disconnection, discontinuity, discreetness, discretion, disengagement, disentanglement, disinterest, disinterestedness, disjointing, disjunction, dislocation, disowning, disownment, disparity, dispassion, dispassionateness, displacement, disposal, disposition, dissatisfaction, dissension, dissent, dissentience, dissidence, dissociation, distance, disunion, disuse, diversity, division, divorce, divorcement, drawing, drawing out, dredging, drilling, dropping out, dullness, egress, ejection, elation, elimination, emeritus status, emotional deadness, emotional insulation, emotionalism, emotionlessness, enucleation, eradication, escape, escape into fantasy, escape mechanism, escapism, euphoria, evacuation, evolvement, evulsion, excavation, excision, exile, exit, exodus, expatriation, expression, expressionlessness, expulsion, exsection, extirpation, extraction, extrication, fallback, fantasizing, fantasy, flight, folie du doute, forced resignation, forsaking, forswearing, frigidity, frostiness, getaway, going, guardedness, heartlessness, heedlessness, hegira, hypochondria, hysteria, hysterics, iciness, immovability, impassibility, impassiveness, impassivity, impersonality, inaccessibility, incoherence, incuriosity, incuriousness, indifference, indifferentism, indifferentness, inexcitability, insensibility, insouciance, intellectual inertia, introversion, invalidation, isolation, isolationism, jettison, jettisoning, keeping apart, lack of affect, lack of feeling, lack of interest, lack of touch, leaving, lethargy, liquidation, listlessness, loneliness, loneness, lonesomeness, luxation, mania, melancholia, mental distress, mining, minority opinion, modesty, moving apart, negativism, nonagreement, nonassent, nonconcurrence, nonconformity, nonconsent, nullification, objectivity, obsession, obtuseness, opposition, ostracism, outlawing, outlawry, overcompensation, palinode, palinody, parting, partition, passing, passionlessness, pathological indecisiveness, poker face, preoccupation, pressing out, privacy, privatism, privatization, projection, psychalgia, psychomotor disturbance, psychotaxis, pullback, pulling, pulling out, pullout, purge, quarantine, quarrying, rationalization, recall, recantation, recedence, receding, recess, recession, reclusion, reculade, recusance, recusancy, regardlessness, rejection, relinquishment, remoteness, removal, renege, reneging, renouncement, renunciation, repeal, repression, repudiation, rescinding, rescindment, rescission, reserve, reservedness, resignation, resistance, restraint, reticence, reticency, retiral, retirement, retractation, retractility, retraction, retreat, retrocedence, reversal, revocation, revoke, revokement, riddance, ripping out, rustication, secession, seclusion, secrecy, segmentation, segregation, self-absorption, separateness, separation, separatism, sequestration, setting aside, severance, single blessedness, sociological adjustive reactions, solitariness, solitude, soullessness, spiritlessness, splendid isolation, squeezing out, standoffishness, stolidity, straight face, stupor, subdivision, sublimation, substitution, subtraction, superannuation, suppression, suspension, throwing overboard, tic, twitching, unaffability, unapproachability, unconcern, uncongeniality, undemonstrativeness, underground, unemotionalism, unexcitability, unexpansiveness, unfeeling, unfeelingness, unimpressibility, unimpressionableness, uninquisitiveness, uninterestedness, unmindfulness, unpassionateness, unresponsiveness, unrooting, unsaying, unsusceptibility, unsympatheticness, untouchability, uprooting, vacation, vacatur, variance, voidance, voiding, voluntary resignation, waiver, waiving, walkout, wish-fulfillment fantasy, wishful thinking, withdrawment, withdrawnness, wresting out, write-off, zoningEnglish
Noun
- Receiving from someone's care what one has earlier entrusted to them. Usually refers to money.
- A method of birth control which consists of removing the penis from the vagina before ejaculation.
- A type of metabolic shock the body undergoes when a
substance, usually a toxin such as heroin, to which a patient is
addicted is withheld. Sometimes used with the substance as modifier
- heroin withdrawal
- nicotine withdrawal
- heroin withdrawal
- An act of withdrawing.
Antonyms
Translations
receiving from someone's care what one has
earlier entrusted to them
- Finnish: nosto qualifier money from a bank, otto qualifier money from a bank
- Japanese: 引き出し, 出金
- Swedish: uttag qualifier money from a bank
a method of birth control
- Finnish: keskeytetty yhdyntä
- French: coïtus interruptus
- Japanese: 膣外射精
- Spanish: coitus interruptus
a type of metabolic shock
an act of withdrawing
- Japanese: 引き出し
- ttbc French: retrait
- ttbc Greek: απόσυρση
- ttbc Italian: ritiro ritrattazione
- ttbc Interlingua: retiramento
- ttbc Portuguese: retirada , saque
- ttbc Spanish: retirada
- For other meanings, see Withdrawal (disambiguation).
Withdrawal, also known as withdrawal/abstinence
syndrome, refers to the characteristic signs and symptoms that
appear when a drug that causes physical
dependence is regularly used for a long time and then suddenly
discontinued or decreased in dosage. The term can also, less
formally, refer to symptoms that appear after discontinuing a drug
or other substance (unable to cause true physical dependence) that
one has become psychologically
dependent upon.
Examples are:
- delirium tremens
- benzodiazepine withdrawal syndrome
- methadone withdrawal symptoms
- SSRI discontinuation syndrome
- neonatal abstinence syndrome
Overview
The sustained use of many kinds of drugs causes reversible adaptations within the body that tend to lessen the drug's original effects over time, a phenomenon known as drug tolerance. To have these adaptations to a drug is to have a physical dependency on it, for when the drug is suddenly discontinued or decreased, the adaptations do not immediately disappear. Unopposed by the drug, the adaptations appear as withdrawal signs and symptoms that are generally the opposite of the drug's direct effects. Depending primarily on the drug's elimination half-life, withdrawal symptoms can appear within a few hours to several days after discontinuation.The withdrawal symptoms associated with many
recreational
drugs are well-known. However, many drugs that do not generally
cause euphoria, and are therefore not generally abused or thought
of as addictive, also induce physical dependence with associated
withdrawal. Examples include beta
blockers, corticosteroids such as
cortisone, many anticonvulsants and most
antidepressants.
Nevertheless, sudden withdrawal from these medications can be
harmful or even fatal; this is why many prescription labels
explicitly warn the patient not to discontinue the drug without
doctor approval.
Withdrawal from drugs of abuse
Central to the role of nearly all drugs that are commonly abused to produce euphoria is the nucleus accumbens, the brain's "pleasure center". Neurons in the nucleus accumbens use the neurotransmitter dopamine, so while specific mechanisms vary, nearly every drug of abuse either stimulates dopamine release or enhances its activity, directly or indirectly. Sustained use of the drug results in less and less stimulation of the nucleus accumbens until eventually it produces no euphoria at all. Discontinuation of the drug then produces a withdrawal syndrome characterized by dysphoria — the opposite of euphoria — as nucleus accumbens activity declines below normal levelsWithdrawal symptoms can vary significantly among
individuals, but there are some commonalities. Subnormal activity
in the nucleus accumbens is often characterized by depression,
anxiety and craving, and if extreme can help
drive the individual to continue the drug despite significant harm
— the definition of addiction — or even
to suicide
However, addiction is to be carefully
distinguished from physical dependence. Addiction is a
psychological compulsion to use a drug despite harm that often
persists long after all physical withdrawal symptoms have abated.
On the other hand, the mere presence of even profound physical
dependence does not necessarily denote addiction, e.g., in a
patient using large doses of opioids to control chronic pain under
medical supervision .
As the symptoms vary, some people are, for
example, able to quit smoking "cold turkey"
(i.e., immediately, without any tapering off) while others may
never find success despite repeated efforts. However, the length
and the degree of an addiction can be indicative of
the severity of withdrawal
Withdrawal is a more serious medical issue for
some substances than for others. While nicotine withdrawal, for
instance, is usually managed without medical intervention,
attempting to give up a benzodiazepine or
alcohol
dependency
can result in seizures
and worse if not carried out properly. An instantaneous full stop
to a long, constant alcohol use can lead to delirium
tremens, which may be fatal .
An interesting side-note is that while physical
dependence (and withdrawal on discontinuation) is virtually
inevitable with the sustained use of certain classes of drugs,
notably the opioids,
psychological addiction is much less common. Most chronic pain
patients, as mentioned earlier, are one example. There are also
documented cases of soldiers who used heroin recreationally in Vietnam
during the war, but who gave it up when they returned home (see
Rat Park
for experiments on rats showing the same results). It is thought
that the severity or otherwise of withdrawal is related to the
person's preconceptions about withdrawal. In other words, people
can prepare to withdraw by developing a rational set of beliefs
about what they are likely to experience. Self-help
materials are available for this purpose .
Withdrawal from prescription medicine
As mentioned earlier, many drugs should not be stopped abruptly without the advice and supervision of a physician, especially if the medication induces dependence or if the condition they are being used to treat is potentially dangerous and likely to return once medication is stopped, such as diabetes, asthma, heart conditions and many psychological or neurological conditions, like epilepsy, hypertension, schizophrenia and psychosis. To be safe, consult a doctor before discontinuing any prescription medication.Sudden cessation of the use of an antidepressant can deepen
the feel of depression significantly (see "Rebound" below), and
some specific antidepressants can cause a unique set of other
symptoms as well when stopped abruptly.
Discontinuation of
selective serotonin reuptake inhibitors (SSRIs), the most
commonly prescribed class of antidepressants, (and the related
class
serotonin-norepinephrine reuptake inhibitors or SNRIs) is
associated with a particular syndrome of physical and psychological
symptoms known as
SSRI discontinuation syndrome. Effexor
(venlafaxine) and Paxil
(paroxetine), both of which have relatively short half-lives
in the body, are the most likely of the antidepressants to cause
withdrawals. Prozac
(fluoxetine), on the other hand, is the least likely of
SSRI and
SNRI
antidepressants to cause any withdrawal symptoms, due to its
exceptionally long half-life.
Rebound
Many substances can cause rebound effects (significant return of the original symptom in absence of the original cause) when discontinued, regardless of their tendency to cause other withdrawal symptoms. Rebound depression is common among users of any antidepressant who stop the drug abruptly, whose states are sometimes worse than the original before taking medication. This is somewhat similar (though generally less intense and more drawn out) than the 'crash' that users of ecstasy, amphetamines, and other stimulants experience. Occasionally light users of opiates that would otherwise not experience much in the way of withdrawals will notice some rebound depression as well. Extended use of drugs that increase the amount of serotonin or other neurotransmitters in the brain can cause some receptors to 'turn off' temporarily or become desensitized, so, when the amount of the neurotransmitter available in the synapse returns to an otherwise normal state, there are fewer receptors to attach to, causing feelings of depression until the brain re-adjusts.Other drugs that commonly cause rebound are:
- Nasal decongestants, such as Afrin (oxymetazoline) and Otrivin (xylometazoline), which can cause rebound congestion if used for more than a few days
- Many analgesics including Advil, Motrin (ibuprofen), Aspirin (acetylsalicylic acid), Tylenol (acetaminophen or paracetamol), and some prescription but non-narcotic painkillers, which can cause rebound headaches when taken for extended periods of time.
- Sedatives and benzodiazepines, which can cause rebound insomnia when used regularly as sleep aids.
With these drugs, the only way to relieve the
rebound symptoms is to stop the medication causing them and weather
the symptoms for a few days; if the original cause for the symptoms
is no longer present, the rebound effects will go away on their
own.
Neonatal abstinence syndrome
Neonatal abstinence syndrome (NAS) is a withdrawal syndrome of infants, caused by administration of drugs. There are two types of NAS, prenatal and postnatal. Prenatal NAS is caused by substance abuse by the mother, while postnatal NAS is caused by discontinuation of drugs directly to the infant.The drugs involved are e.g. opioids,
selective serotonin reuptake inhibitors (SSRIs) and alcoholic
beverages. to describe signs of withdrawal although the dose
remains constant. Such signs may arise in use of benzodiazepines
and amphetamine.
See also
References
External links
withdrawal in German: Entzugssyndrom
withdrawal in Spanish: Síndrome de
abstinencia
withdrawal in French: Sevrage
(toxicologie)
withdrawal in Italian: Crisi d'astinenza
withdrawal in Hebrew: גמילה
withdrawal in Lithuanian: Abstinencijos
sindromas
withdrawal in Dutch:
Ontwenningsverschijnselen
withdrawal in Norwegian: Abstinens
withdrawal in Polish: Zespół abstynencyjny
withdrawal in Russian: Абстинентный
синдром
withdrawal in Finnish: Vieroitusoire
withdrawal in Turkish: Yoksunluk
sendromu