Strategies for discontinuing long-term benzodiazepine use

Abstract

Evidence was found for the efficacy of stepped care (minimal intervention followed by systematic discontinuation alone) in discontinuing long-term benzodiazepine use.

Minimal interventions to decrease long-term use of benzodiazepines in primary care: a systematic review and meta-analysis

“…20 Most of these interventions, however, involved levels of skill and resource usage that would not be feasible for widespread use. The letter interventions used were similar in the trials, and were adapted from the first study by Cormack et al 17 In their letters, both Cormack et al and Heather et al explained why BZDs should not be continued for prolonged periods.…”

Older Patient Perspectives on Long-Term Anxiolytic Benzodiazepine Use and Discontinuation: A Qualitative Study

“…[1][2][3][4][5] Drug-disease interaction and chronicity of use are two other common problems associated with benzodiazepine use in this population. 6 As Oude Voshaar et al 7 point out, there is limited evidence suggesting the long-term efficacy in two specific diagnostic groups: panic disorder and social phobia, and the prevalence of these specific disorders among those who are long-term users is relatively low. Indeed, many community-residing older long-term benzodiazepine users do not have any mental health problem.…”

Benzodiazepine Substitution for Dependent Patients—going With the Flow

“…Liebrenz et al [7] remind us of an uncomfortable truth; that despite all the good intentions and efforts to stop people taking benzodiazepines when they are dependent, they have failed and failed again, so that all that we can really recommend on the basis of good evidence is that benzodiazepines are reduced gradually [8]. Not only do people with high-dose dependence fail to withdraw successfully but those with low-dose dependence fail frequently too, and in personal studies we found attempts to persuade people not to take these drugs after they had been through the process of withdrawal successfully were thwarted; a majority returned to taking them in the longer term, not often regularly, but sufficiently to make a nonsense of the apparent triumph of stopping their drugs completely [9].…”