In‐patient withdrawal from long‐term benzodiazepine use

Abstract

Twenty-one patients completed an intensive in-patient and out-patient group-based programme, to achieve withdrawal from long-term benzodiazepine dependence. By 6-month follow-up (post-withdrawal), eight patients (38%) had achieved a 'good' outcome. Generally, patients demonstrated moderate levels of psychiatric morbidity and depression in the pre-withdrawal phase; a diagnosis of a depressive disorder being associated with either an 'intermediate' or 'poor' outcome in comparison to patients receiving a diagnosis of anxiety disorder, who showed a predominantly 'good' outcome. Two patients committed suicide some time after withdrawal. Additionally, older patients fared less well than their younger counterparts. We conclude that maintenance benzodiazepine prescription, rather than withdrawal, may be the preferred treatment for some dependent patients. Furthermore, more data are required regarding the association, and causality, between depression and benzodiazepine withdrawal in long-term users.

Which way to treat obesity? Emotional, eating and behavioural issues in dieting

“…On average the CSG sample showed a broadly normal psychological profile with low-tomedium anxiety scores and low levels of depression (Table 1). Self-efficacy skills in F1: Pride and Coping, F2: Expectations in Interpersonal Situations and F3: Life Control, were higher than the norms previously obtained from a general sample of the local population (Joughlin et al, 1991) but self-esteem appeared lower, resulting in a mean total score slightly lower than the norms.…”

“…Depression: > I 2 (high), 4-12 (medium), < 9 (low). Self-efficacy: Normative values for the Tooting Population (Joughlin, 1991) F1, range 12.94-17.78, mean 15.91; F2, range 10.32-11.72, mean 10.89; F3, range 10.56-13.56, mean 12.07; F4, range 8.17-10.53, mean 9.72. attended week 1 and week 6 of the weight loss programme.…”

Treatment of Benzodiazepine Dependence in Methadone Maintenance Treatment Patients: A Comparison of Two Therapeutic Modalities and the Role of Psychiatric Comorbidity

“…[8] described 3/5 MMT patients who were successfully detoxified from alprazolam with phenobarbitol, but they had no or only minimal follow‐up. Another study [9] in which the investigators used a very intensive inpatient BZD‐tapered discontinuation procedure reported a 67% success rate at 6 months. Using clonazepam as a tapering agent for 37 patients treated with alprazolam for anxiety disorders, Patterson [12] reported a 100% success rate at 1 month follow‐up.…”

“…Limited research has been done on treatment modalities for BZD dependence and even less on BZD‐dependence treatment in heroin addicts or MMT patients. Most investigations have centred on the tapered detoxification of BZD with [8] or without [9] substitution by a barbiturate (e.g. phenobarbitol) or a long‐acting BZD (e.g.…”

Assessing the Risks and Benefits of Benzodiazepines for Anxiety Disorders in Patients with a History of Substance Abuse or Dependence

“…Some of these patients feel less anxious once BZDs have been withdrawn, 104,105,139 while others experience a recurrence of anxiety. Table 4 summarizes the percent of patients referred to BZD discontinuation clinics who ultimately remained symptom‐free once tapered 23,104,105,139,173−178 . From this data, it appears that roughly 40% to 50% of patients maintained on long‐term BZD therapy are either no longer deriving clinical benefit or can be successfully treated with an alternative anxiolytic agent.…”