Need for a realistic appraisal of benzodiazepines

Balon, Richard; Fava, Giovanni A.; Rickels, Karl

doi:10.1002/wps.20219

Cited by 19 publications

(12 citation statements)

References 16 publications

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“…The current study highlights the need to assess at an individual level which substances or treatment options are replacing BZD use in the population by using an observational, register‐based methodology. This is important, because different substances have different risk‐benefit profiles, and these should be taken into account while considering substitutes for BZD use …”

Section: Discussionmentioning

confidence: 99%

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Trends in the long‐term use of benzodiazepine anxiolytics and hypnotics: A national register study for 2006 to 2014

Kurko

Saastamoinen

Tuulio‐Henriksson

et al. 2018

Pharmacoepidemiology and Drug

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Section: Discussionmentioning

confidence: 99%

“…This is important, because different substances have different risk-benefit profiles, and these should be taken into account while considering substitutes for BZD use. 8,62…”

Section: The Use Long-term Use and High-dose Use Of The Most Commmentioning

confidence: 99%

Trends in the long‐term use of benzodiazepine anxiolytics and hypnotics: A national register study for 2006 to 2014

Kurko

Saastamoinen

Tuulio‐Henriksson

et al. 2018

Pharmacoepidemiology and Drug

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“…To our knowledge, this is the first study to use qualitative methodology to explore high-dose BZD-dependent patients’ attitudes towards an agonist treatment approach. While the clinical aspects are perceived as beneficial, our findings suggest that participants’ moral convictions about dependence, and their perceptions about the beliefs of treating physicians [ 34 ], are particularly contentious issues [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Attitudes towards a maintenance (-agonist) treatment approach in high-dose benzodiazepine-dependent patients: a qualitative study

et al. 2016

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BackgroundHigh-dose benzodiazepine dependence constitutes a major clinical concern. Although withdrawal treatment is recommended, it is unsuccessful for a significant proportion of affected patients. More recently, a benzodiazepine maintenance approach has been suggested as an alternative for patients’ failing discontinuation treatment. While there is some data supporting its effectiveness, patients’ perceptions of such an intervention have not been investigated.MethodsAn exploratory qualitative study was conducted among a sample of 41 high-dose benzodiazepine (BZD)-dependent patients, with long-term use defined as doses equivalent to more than 40 mg diazepam per day and/or otherwise problematic use, such as mixing substances, dose escalation, recreational use, or obtainment by illegal means. A qualitative content analysis approach was used to evaluate findings.ResultsParticipants generally favored a treatment discontinuation approach with abstinence from BZD as its ultimate aim, despite repeated failed attempts at withdrawal. A maintenance treatment approach with continued prescription of a slow-onset, long-acting agonist was viewed ambivalently, with responses ranging from positive and welcoming to rejection. Three overlapping themes of maintenance treatment were identified: “Only if I can try to discontinue…and please don’t call it that,” “More stability and less criminal activity…and that is why I would try it,” and “No cure, no brain and no flash…and thus, just for everybody else!”ConclusionsSome patients experienced slow-onset, long-acting BZDs as having stabilized their symptoms and viewed these BZDs as having helped avoid uncontrolled withdrawal and abstain from criminal activity. We therefore encourage clinicians to consider treatment alternatives if discontinuation strategies fail.

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“…Their large number of prescriptions raised many concerns and attempts at limiting their use [5] . The introduction of second-generation antidepressant and antipsychotic drugs has provided more expensive modalities of addressing anxiety disorders [7] . Substituting benzodiazepines with selective serotonin reuptake inhibitors (SSRI) and serotonin-noradrenaline reuptake inhibitors (SNRI) clearly appeared the commercial way to go.…”

mentioning

confidence: 99%

“…The other complementary strategy was to magnify the side effects of benzodiazepines. Since these negative aspects are actually very limited [5][6][7][8] , the potential for dependency, toxicity and abuse had to be pictured dramatically, despite the fact that the percentage of recreational abuse is uncommon and the abuse is really low in relation to the number of people using them [10] . The reinforcing effects of benzodiazepines vary and are considerably weaker than those of other drugs of abuse such as other sedative hypnotics, stimulants and opiates [10] .…”

mentioning

confidence: 99%

Clinical Methodology Matters in Epidemiology: Not All Benzodiazepines Are the Same

Cosci

Guidi

Balon³

et al. 2015

Psychother Psychosom

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Need for a realistic appraisal of benzodiazepines

Cited by 19 publications

References 16 publications

Trends in the long‐term use of benzodiazepine anxiolytics and hypnotics: A national register study for 2006 to 2014

Trends in the long‐term use of benzodiazepine anxiolytics and hypnotics: A national register study for 2006 to 2014

Attitudes towards a maintenance (-agonist) treatment approach in high-dose benzodiazepine-dependent patients: a qualitative study

Clinical Methodology Matters in Epidemiology: Not All Benzodiazepines Are the Same

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