Pharmacological interventions for benzodiazepine discontinuation in chronic benzodiazepine users

Abstract

Given the low or very low quality of the evidence for the reported outcomes, and the small number of trials identified with a limited number of participants for each comparison, it is not possible to draw firm conclusions regarding pharmacological interventions to facilitate benzodiazepine discontinuation in chronic benzodiazepine users. Due to poor reporting, adverse events could not be reliably assessed across trials. More randomised controlled trials are required with less risk of systematic errors ('bias') and of random errors ('play of chance') and better and full reporting of patient-centred and long-term clinical outcomes. Such trials ought to be conducted independently of industry involvement.

Polypharmacy in schizophrenia

“…Add‐on medications to facilitate benzodiazepine discontinuation have been extensively investigated. In a recent Cochrane Review covering the topic, the following results were emphasized: several different pharmacological interventions had been investigated but mostly in underpowered studies of low scientific quality. Most results were based on single small‐sized randomized trials with a high risk of type II error.…”

Benzodiazepine Use and Falls in Older Adults: Is It Worth the Risk?

“…Priorities for further research include adequately powered, high-quality, randomized controlled trials comparing pharmacological interventions to facilitate BZD discontinuation in chronic BZD users. Th ese trials need to be conducted with minimal bias, be independent of industry involvement, and include adverse effects, along with patient-centered and long-term clinical outcomes (Baandrup et al, 2018). Randomized controlled trials in participants newly prescribed BZDs need to take the "new user" eff ect into consideration and outline clearly in the patient information sheet what to expect and what routine tasks to avoid (Díaz-Gutiérrez et al, 2017).…”

Tackling benzodiazepine misuse

“…However, there is a paucity of evidence for effective interventions to support withdrawal, and a recent review failed to identify evidence of sufficient quality to support any pharmacological interventions. 18 Psychosocial interventions may be more promising: cognitive behavioural therapy plus tapering is effective in the short term, and relaxation techniques and individualised GP letters to patients can facilitate withdrawal. 3 However, better evidence is urgently required for both drug and non-drug options.…”