Patient Vernacular:  Windows and Waves

If your patient has self-diagnosed their physiologic dependence on benzodiazepines, there is a good chance that they have done it via internet searches and contacts.  There is a set of well-established terms in common use in the online benzodiazepine withdrawal sufferer community.  Prescriber-patient communication can be eased and facilitated when the prescriber takes the time to understand these terms.  Among these terms, “windows” and “waves” are particularly important. The evidence-based literature does not use this terminology, but does speak to spikes in severity of symptoms .

During withdrawal (whether due to tolerance or tapering) and recovery, patients often experience an irregular, unpredictable cycling between relative lessening and exacerbation of symptoms.  This cycling can occur in a very short time (minutes), and can range to a substantial time (months).  Which symptoms increase or decrease in any of these cycles is also unpredictable.  The cause of this cycling has been the subject of much speculation, and is one of the areas of research by the Alliance (see Initiatives).

The lessening of symptoms is termed a “window”, as in a window to the patient’s condition prior to exposure to benzodiazepines.  The increase of symptoms is termed a “wave”, as in being engulfed in a wave of symptoms.