To take back or away, as what has been bestowed
or enjoyed; to draw back; to cause to move away or retire; as, to
withdraw aid, favor, capital, or the like. [1913 Webster]
Impossible it is that God should withdraw his presence from
anything. --Hooker. [1913 Webster]
To take back; to recall or retract; as, to
withdraw false charges. [1913 Webster]
Withdraw \With*draw"\, v. i. To retire; to
retreat; to quit a company or place; to go away; as, he withdrew
from the company. "When the sea withdrew." --King Horn. [1913
Webster] Syn: To recede; retrograde; go back. [1913 Webster]
Word Net
withdrawVerb
1 pull back or move away or backward; "The enemy
withdrew"; "The limo pulled away from the curb" [syn: retreat, pull away,
draw
back, recede,
pull
back, retire,
move
back]
2 withdraw from active participation; "He retired
from chess" [syn: retire]
3 release from something that holds fast,
connects, or entangles; "I want to disengage myself from his
influence"; "disengage the gears" [syn: disengage] [ant: engage]
4 cause to be returned; "recall the defective
auto tires"; "The manufacturer tried to call back the spoilt
yoghurt" [syn: recall,
call in,
call
back]
6 keep away from others; "He sequestered himself
in his study to write a book" [syn: seclude, sequester, sequestrate]
7 remove something concrete, as by lifting,
pushing, taking off, etc. or remove something abstract; "remove a
threat"; "remove a wrapper"; "Remove the dirty dishes from the
table"; "take the gun from your pocket"; "This machine withdraws
heat from the environment" [syn: remove, take, take
away]
8 break from a meeting or gathering; "We
adjourned for lunch"; "The men retired to the library" [syn:
adjourn, retire]
9 retire gracefully; "He bowed out when he
realized he could no longer handle the demands of the chairmanship"
[syn: bow
out]
10 remove (a commodity) from (a supply source);
"She drew $2,000 from the account"; "The doctors drew medical
supplies from the hospital's emergency bank" [syn: draw, take out,
draw
off] [ant: deposit]
11 lose interest; "he retired from life when his
wife died" [syn: retire]
12 make a retreat from an earlier commitment or
activity; "We'll have to crawfish out from meeting with him"; "He
backed out of his earlier promise"; "The aggressive investment
company pulled in its horns" [syn: retreat, pull back,
back
out, back away,
crawfish, crawfish
out, pull
in one's horns] [also: withdrew, withdrawn]
Moby Thesaurus
abandon, abate, abdicate, abjure, abolish, abrade, abrogate, abrupt, abscond, abstract, agree to differ, agree to disagree, alienate, annul, avulse, back down, back out, backwater, bate, be at variance, be in dissent, be pensioned, be superannuated, beat a retreat, become an individual, beg off, beg to differ, blow, bow out, cancel, cast off, cast out, climb down, countermand, counterorder, crawfish out, cringe, cry off, curtail, cut adrift, cut off, cut out, decline, decrease, deduct, delete, demit, deny, depart, depart from, depreciate, deracinate, derogate, detract, die away, differ, dig out, dig up, diminish, disagree, disagree with, disannul, disappear, disarticulate, disavow, discard, disclaim, disconnect, discord with, disengage, disentangle, disjoin, disjoint, disown, disparage, dissent, dissent from, dissociate, disunite, divide, divide on, divorce, do away with, drain, draw, draw back, draw in, draw off, draw out, dredge, dredge up, drift away, drop out, duck, dwindle, eat away, eat crow, eat humble pie, ebb, eject, eradicate, erode, estrange, evacuate, evolve, evulse, excavate, excise, exit, expel, exsect, extract, extricate, fade, fade away, fall back, file away, flinch, forsake, forswear, get away, get off, get out, give back, give ground, give place, give up, give way, go, go away, go back, go back on, gouge out, grub up, impair, invalidate, isolate, jettison, jilt, keep apart, leach, leave, leave behind, leave flat, lessen, make void, maroon, mine, move away, move back, move off, not agree, nullify, oppose, override, overrule, palinode, part, pension off, pick out, pluck out, pluck up, pull, pull away, pull back, pull in, pull out, pull up, purify, quail, quarry, quit, quit cold, rake out, recall, recant, recede, recoil, reduce, refine, relinquish, remove, renege, renounce, renounce the throne, repeal, repudiate, rescind, resign, retire, retire from office, retract, retreat, retrench, retrocede, reverse, revoke, rip out, root out, root up, rub away, run along, run back, say goodbye to, secede, segregate, separate, sequester, set apart, set aside, shorten, shrink, shut off, shy, sink, split, stand alone, stand aloof, stand apart, stand aside, stand back, stand down, stand off, step aside, subduct, subtract, superannuate, suspend, swallow, take away, take back, take exception, take from, take issue, take leave of, take off, take out, tear out, thin, thin out, throw off, throw out, throw over, uncouple, unearth, unravel, unsay, unyoke, uproot, vacate, vanish, void, waive, wane, wear away, weed, weed out, widen the distance, wince, withdraw from, withhold assent, wrest out, write offEnglish
Verb
Translations
pull back
- Czech: stáhnout
- Dutch: terugtrekken
- Finnish: vetää takaisin
- French: retirer
- German: zurückziehen
- Japanese: 引き出す (ひきだす, hikidasu)
- Old English: oftēon
- Portuguese: retirar
- Spanish: retirar
- Telugu: ఉపసంహరించు (upasaMhariMchu)
take back
- Dutch: terugnemen
- Finnish: ottaa takaisin, perua
- French: retirer
- German: zurücknehmen
- Japanese: 引き出す (ひきだす, hikidasu)
- Old English: oftēon
- Portuguese: devolver
- Telugu: ఉపసంహరించు (upasaMhariMchu)
remove, stop providing
extract (money from an account)
retreat
- Dutch: terugtrekken
- Finnish: perääntyä
- French: se retirer
- German: sich zurückziehen, abziehen
- Portuguese: retirar-se
- ttbc French: tirer, retirer
- ttbc Indonesian: menarik, membatalkan
- ttbc Spanish: retirar
- 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
withdraw in German: Entzugssyndrom
withdraw in Spanish: Síndrome de
abstinencia
withdraw in French: Sevrage (toxicologie)
withdraw in Italian: Crisi d'astinenza
withdraw in Hebrew: גמילה
withdraw in Lithuanian: Abstinencijos
sindromas
withdraw in Dutch:
Ontwenningsverschijnselen
withdraw in Norwegian: Abstinens
withdraw in Polish: Zespół abstynencyjny
withdraw in Russian: Абстинентный синдром
withdraw in Finnish: Vieroitusoire
withdraw in Turkish: Yoksunluk
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