Personality and symptom sensitivity predictors of alprazolam withdrawal in panic disorder

Roy‐Byrne, Peter; Russo, Joan; Pollack, Mark H.; Stewart, Roy E.; Bystrisky, Alexander; Bell, Jonathan; Rosenbaum, J. F.; Corrigan, Malachy; Stolk, Jon M.; Rush, A. John; Ballenger, James C.

doi:10.1017/s0033291703007402

Cited by 10 publications

(5 citation statements)

References 16 publications

(27 reference statements)

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“…In addition, a recently published study demonstrated that psychological and personality factors also play a role in the severity of withdrawal symptoms. 38 However, because withdrawal symptoms of variable severity may appear in parallel with rebound symptoms of a panic disorder, usually peaking toward the end of the taper period, it usually takes 2 to 4 benzodiazepine-free weeks to discern the nature of the emerging symptoms. 39 Thus, symptoms upon tapering or cessation of therapy may represent a discontinuation syndrome or reemergence of the anxiety disorder.…”

Section: Discontinuation Of High-potency Benzodiazepine Therapymentioning

confidence: 99%

The Role of High-Potency Benzodiazepines in the Treatment of Panic Disorder

Susman¹,

Klee²

2005

Prim. Care Companion CNS Disord.

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Section: Discontinuation Of High-potency Benzodiazepine Therapymentioning

confidence: 99%

The Role of High-Potency Benzodiazepines in the Treatment of Panic Disorder

Susman¹,

Klee²

2005

Prim. Care Companion CNS Disord.

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“…Generalised anxiety disorder (GAD) is a highly prevalent mental condition and like other anxiety disorders can lead to severely impaired social functioning [44,55] and increased use of costly medical services [36]. GAD requires pharmacologic [6,9,55] and/or psychological treatment [10,49].…”

Section: Introductionmentioning

confidence: 99%

A 12-month comparison of brief psychodynamic psychotherapy and pharmacotherapy treatment in subjects with generalised anxiety disorders in a community setting

Ferrero

Pierò

Fassina³

et al. 2007

Eur. psychiatr.

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Little information is available on the use of brief psychotherapy among subjects with generalised anxiety disorder (GAD) within community mental health services. This study compared results among subjects treated with brief Adlerian psychodynamic psychotherapy (B-APP), those treated with medication (MED), or those who experienced combined treatment (COM). Symptomatology and occupational functioning were assessed using the Hamilton Anxiety and Depression scales (HAM-A; HAM-D), Clinical Global Impression (CGI), and Social and Occupational Functioning Assessment Scale (SOFAS) at intake (T1) and at 3, 6, and 12 months later (T3, T6, T12). The study sample included 87 patients with GAD (B-APP 34; MED 33; COM 20), and an ANOVA was applied for analysing repeated measures while controlling for personality disorder. After 6 months, CGI, HAM-A, HAM-D, and SOFAS scores significantly improved independently from the type of treatment. Subjects with personality disorders treated with B-APP exhibited superior results to those treated using other methods only in SOFAS scores at T6. These results were generally maintained at T12. Remission rates among subjects (HAM-A scores <7) varied between 55% (MED) and 74% (B-APP) at T6 and between 63% (MED) and 78% (COM) at T12; no significant differences appeared between the three treatment groups. A logistic regression model predicted anxiety remission only by CGI at T1. This paper discusses these results in relation to the use of brief psychotherapy within community mental health services.

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“…However, studies on the effectiveness of brief interventions do not take into account the link between BZD use and the initial pathology, and indeed rarely include a diagnosis of these or other specific pathologies. Addiction to BZD may certainly be a disorder in itself (i.e., primary disorder), aggravated by the duration of use and the half-life of the drug, which are among the predictors of withdrawal failure; but it is the psychopathological variables [ 86 , 87 , 88 , 89 , 90 , 91 ] (e.g., psychological suffering, anxiety or insomnia) which best predict relapse rates in withdrawal programs.…”

Section: Cognitive Behavioral Therapy (Cbt) For Discontinuing Long-term Benzodiazepine Use In Insomnia and Anxiety Disordersmentioning

confidence: 99%

Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for the Discontinuation of Long-Term Benzodiazepine Use in Insomnia and Anxiety Disorders

Chapoutot

Peter‐Derex

Bastuji

et al. 2021

IJERPH

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Benzodiazepines have proven to be highly effective for treating insomnia and anxiety. Although considered safe when taken for a short period of time, a major risk–benefit dilemma arises in the context of long-term use, relating to addiction, withdrawal symptoms, and potential side effects. For these reasons, benzodiazepines are not recommended for treating chronic sleep disorders, anxiety disorders, nor for people over the age of 65, and withdrawal among long-term users is a public health issue. Indeed, only 5% of patients manage to discontinue using these drugs on their own. Even with the help of a general practitioner, this rate does not exceed 25 to 30% of patients, of which approximately 7% manage to remain drug-free in the long term. Cognitive Behavioral Therapies (CBT) offer a crucial solution to this problem, having been shown to increase abstinence success to 70–80%. This article examines traditional and novel CBT techniques in this regard, such as Acceptance and Commitment Therapy, which address both the underlying condition (insomnia/anxiety) and the substance-related disorder. The theoretical framework and evidence supporting the use of these approaches are reviewed. Finally, current research gaps are discussed, and key research perspectives are proposed.

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Personality and symptom sensitivity predictors of alprazolam withdrawal in panic disorder

Cited by 10 publications

References 16 publications

The Role of High-Potency Benzodiazepines in the Treatment of Panic Disorder

The Role of High-Potency Benzodiazepines in the Treatment of Panic Disorder

A 12-month comparison of brief psychodynamic psychotherapy and pharmacotherapy treatment in subjects with generalised anxiety disorders in a community setting

Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for the Discontinuation of Long-Term Benzodiazepine Use in Insomnia and Anxiety Disorders

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