Gradual Withdrawal of Diazepam After Long-Term Therapy

Tyrer, Peter; Owen, R T; Dawling, Sheila

doi:10.1016/s0140-6736(83)92355-3

Cited by 256 publications

(87 citation statements)

References 14 publications

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“…However the prevalence of benzodiazepine dependency was found to be 54 per cent. This is higher than the quoted prevalence rate of 15-44 per cent in other studies 2,3,4 .…”

Section: Discussioncontrasting

confidence: 62%

“…The prevalence of use has been recorded at 70 per cent in a study of patients on a methadone maintenance programme, whereby the patterns and doses of diazepam used were primarily abusive rather than therapeutic 1 . An estimation of benzodiazepine dependency has been rated as being between 15 per cent and 44 per cent 2,3,4 . Research indicates that benzodiazepine polydrug users are more likely to inject, to share injected equipment and have a higher risk of H.I.V.…”

Section: Introductionmentioning

confidence: 99%

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Co-abuse of opiates and benzodiazepines

et al. 1999

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The objective of the study was to assess what differences exist between individuals who are dependent on opiates and benzodiazepines and compare to those who are dependent on opiates. A questionnaire was compiled and administered to patients who had been consecutively admitted to an inpatient drug treatment unit. The prevalence of benzodiazepine dependency was 54 per cent [n=34]. Patients dependent on benzodiazepines and opiates were significantly older, had been admitted for methadone stabilisation and were more likely to have been prescribed a methadone maintenance programme prior to admission. They had used heroin longer, benzodiazepines more frequently, at larger doses for a longer duration of time and tended to use more drugs in general. They were found to be more psychologically vulnerable than those not dependent on benzodiazepines as they were significantly more likely to have described a past experience of depression and a past episode of deliberate self harm.

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“…However the prevalence of benzodiazepine dependency was found to be 54 per cent. This is higher than the quoted prevalence rate of 15-44 per cent in other studies 2,3,4 .…”

Section: Discussioncontrasting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Co-abuse of opiates and benzodiazepines

et al. 1999

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“…On the other hand, those with high General Neurotic Syndrome Scale scores should be approached very differently and the therapist should anticipate a persistent or relapsing course. Care should be taken in prescribing drugs such as benzodiazepines, as these are much more likely to lead to pharmacological dependence in patients with obsessive-compulsive and dependent personality traits [29], and preference should be made for psychological treatments in which dependent traits in particular may aid the success of treatment [18]. …”

Section: Discussionmentioning

confidence: 99%

The General Neurotic Syndrome: A Re-Evaluation

Tyrer

Guo

2016

Psychother Psychosom

Self Cite

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“…25 mg. These pseudo-withdrawal symptoms were studied by Tyrer et al (1983) and Busto et al (1986), who stress the importance of the patient's personality and suggestibility in their onsets. Another chronological observation is that most cases of withdrawal symptoms occur within the ®rst few Hum.…”

Section: Study Drop-outsmentioning

confidence: 99%

Use of zolpidem 10 mg as a benzodiazepine substitute in 84 patients with insomnia

Allain

Coz²,

Borderies³

et al. 1998

Hum. Psychopharmacol. Clin. Exp.

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The antagonistic eects of zolpidem 10 mg on withdrawal symptoms caused by abrupt or gradual discontinuation (half-dose over 4 nights) of triazolam 0 . 25 mg in patients with chronic insomnia, who had been receiving regular treatment for over one month, were assessed in a randomized, double-blind, placebo-controlled clinical trial in general practice. Eighty-four patients were enrolled, mostly women (67 . 9%), with a mean age of 54 . 3+ 11 . 0 years. Twenty-one dierent general practitioners were solicitated for the recruitment. The subjects were randomized into four groups, and all received triazolam 0 . 25 mg during the run-in phase from day 1 (D1) to day 3 (D3). The following treatments were given from D4 to D7: triazolam 0 . 125 mg zolpidem 10 mg (Group 1); zolpidem 10 mg (Group 2); placebo (Group 3); or triazolam 0 . 125 mg placebo (Group 4). Groups 1 and 2 received zolpidem 10 mg from D7 to D24, while Groups 3 and 4 received placebo. Finally, all four groups received placebo (blind withdrawal phase) from D25 to D28. The following assessment criteria were used: clinical global impression (CGI) scale completed by the practitioner; patient questionnaire based on routine sleep criteria, wakefulness and daytime alertness. Secondary criteria were sleep diaries and visual analogue scales. Study drop-outs were reported and explained. The eectiveness/tolerance ratio was found to be statistically signi®cant using the CGI ( p 5 0 . 007) in favour of zolpidem 10 mg. There was no signi®cant dierence in patients subjective assessment between the groups except for nightmares (p 5 0 . 04) less frequent in patients receiving zolpidem. Zolpidem was found to be more eective than placebo at D21 (CGI) according to sleep diaries; the zolpidem group showed a statistically signi®cant dierence as compared to the three other concerning four sleep parameters: number of awakenings, anxiety, sleep duration, energy. Drop-out rates were signi®cantly lower in the zolpidem group than in other ones (p 5 0 . 01). Abrupt and gradual triazolam withdrawal over 4 nights induced withdrawal symptoms. Equally no speci®c phenomena were observed at the end of the trial during the blind withdrawal phase. This study shows that zolpidem 10 mg improves sleep quality and reduces withdrawal symptoms after abrupt or gradual discontinuation of triazolam 0 . 25 mg in chronic patients with chronic insomnia. #

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Gradual Withdrawal of Diazepam After Long-Term Therapy

Cited by 256 publications

References 14 publications

Co-abuse of opiates and benzodiazepines

Co-abuse of opiates and benzodiazepines

The General Neurotic Syndrome: A Re-Evaluation

Use of zolpidem 10 mg as a benzodiazepine substitute in 84 patients with insomnia

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