Trazodone in Benzodiazepine Dependence

Ansseau, Marc; Roeck, J. De

doi:10.1097/00002826-199202001-01236

Cited by 14 publications

(18 citation statements)

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“…This Þnding is in contrast to the uncontrolled report by Ansseau and de Roeck (1993), whose in-patients were able to stop their benzodiazepine intake during concomitant treatment with trazodone. These authors suggested that trazodone treatment may have resulted in a reduction in severity of discontinuation symptoms, though without a placebo comparator group this is impossible to determine.…”

Section: Discussioncontrasting

confidence: 88%

“…It was more e¤ective in being able successfully to taper a patient o¤ a benzodiazepine than in decreasing severity of withdrawal symptomatology. Subsequent uncontrolled reports suggest that valproate (Keck et al 1992), and trazodone (Ansseau et al 1993), may also be helpful in both decreasing the severity of withdrawal and allowing patients to taper successfully.…”

Section: Introductionmentioning

confidence: 99%

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Trazodone and valproate in patients discontinuing long-term benzodiazepine therapy: effects on withdrawal symptoms and taper outcome

et al. 1999

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Recent uncontrolled research suggested that trazodone and sodium valproate may be helpful in benzodiazepine (BZ) discontinuation. We therefore undertook a double-blind study to assess whether trazodone and valproate, as compared to placebo, would attenuate withdrawal and facilitate discontinuation in BZ-dependent patients with a minimum of 1 year daily BZ use. Seventy-eight patients, taking a mean dose of 19+/-17 mg/day of diazepam (or its equivalent), were stabilized for several weeks on their BZ (16 diazepam, 25 lorazepam, 37 alprazolam) and then for 1-2 weeks, pretreated with trazodone, sodium valproate or placebo before being tapered at 25% per week. All treatments were continued for 5 weeks post-taper. BZ-free status was assessed after 5 and 12 weeks post-taper. Neither trazodone nor valproate had any significant effect on withdrawal severity. Peak physician withdrawal checklist change from baseline to peak severity was 16.4 for trazodone, 18.04 sodium valproate and 18.24 placebo (F = 0.10; NS). Taper success rates were significantly effected by both active agents at the 5-week, but not 12-week, assessment. At 5 weeks post-taper, 79% of sodium valproate and 67% of trazodone, but only 31% of placebo patients were BZ-free (chi2 = 7.34; df 2; P<0.03). Major adverse events for trazodone were sedation and dry mouth, and for valproate, diarrhea, nausea and headaches.

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Section: Discussioncontrasting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Trazodone and valproate in patients discontinuing long-term benzodiazepine therapy: effects on withdrawal symptoms and taper outcome

et al. 1999

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“…Trazodone, a non-tricyclic sedative antidepressant, is frequently used in low doses as a hypnotic. It has also been proposed as a convenient agent for the substitution of BZDs in withdrawal programmes (78)(79)(80). Trazodone is particularly effective for patients with depression-associated insomnia.…”

Section: Alternative Treatmentmentioning

confidence: 99%

Is There a Rationale for Prescription of Benzodiazepines in the Elderly? Review of the Literature

Petrovic

Mariman

Warie

et al. 2003

Acta Clinica Belgica

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Benzodiazepines (BZDs) constitute the most widely used symptomatic treatment of insomnia and anxiety. Many of these drugs are associated with adverse effects, such as daytime sedation and dependence with continued use. There is a concern about the rationale for and extent of benzodiazepine (BZD) use in the elderly. The sedation due to BZD use is a main risk factor for falls and other accidents. Impaired cognitive function with continuous use appears to be a major side effect. There is a general awareness that BZD use is inappropriate in many patients, and therefore discontinuation should be recommended whenever possible. Moreover, long-term use of these drugs should be actively discouraged. Although no unanimous recommendations concerning the optimal duration of the withdrawal process exist, BZDs may easily be withdrawn during a short period in most patients who are habituated to a low dose, if an initial phase with dose reduction and psychological support are provided. Alternative approaches involve sleep hygiene guidelines, behavioural treatment and psychotherapy tailored to the needs of the individual patient.

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“…A great variety of agents have been used as adjuvant medication in BWS with varying degrees of success. Such agents include antidepressants such as mirtazapine [14], paroxetine [15], trazodone [16,17], dothiepin [18] and imipramine…”

Section: Introductionmentioning

confidence: 99%

Anticonvulsant Agents for the Management of Benzodiazepine Dependence

Marín-Mayor¹,

López‐Muñoz²,

Rubio³

2014

AAD

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IntroductionChronic use of Benzodiazepines (BZDs) can lead to tolerance and dependence, as indicated by a BZD Withdrawal Syndrome (BWS). In general, it is preferred a gradual than an abrupt tapering of BZDs as a first step in the treatment of BZD Dependence (BD). In addition, a great variety of agents have been used as adjuvant medication for BD. Recently, research has focused in the use of Anticonvulsant (AC) drugs. The aim of this article is to review the use of AC in the management of BWS and BD. MethodsMEDLINE and the Cochrane were searched, selecting studies from 1980 until 2014, in which a pharmacological intervention with classic and new AC was made for discontinuing long-term BZD use. ResultsIn regard to classic AC, there were identified 10 studies related to carbamazepine and 4 studies related to valproate. On one hand, whereas there is a great body of research involving carbamazepine and there is a consensus about its efficacy for discontinuing long-term BZD use, especially in terms of improving drug-free outcomes, there have been brought inconclusive results in regard to valproate. On the other hand, studies identified of the new AC are as follows: 2 for gabapentin, 2 for oxcarbazepine, 2 for pregabalin, 1 for tigabine and 2 for topiramate. With the exception of pregabalin, only small studies and cases report have been conducted for most of the new AC. Pregabalin has demonstrated to be effective in the treatment of BD and BWS, exerting its beneficial action by reducing the severity of withdrawal and anxiety symptoms. ConclusionTo date, among AC agents, only carbamazepine and pregabalin can be considered as augmentation alternatives for the treatment of long-term BZD use. Further randomized, double-blind, placebo-controlled studies are necessary to increase the knowledge to support the use of AC for the treatment of BD and BWS.

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Trazodone in Benzodiazepine Dependence

Cited by 14 publications

References 0 publications

Trazodone and valproate in patients discontinuing long-term benzodiazepine therapy: effects on withdrawal symptoms and taper outcome

Trazodone and valproate in patients discontinuing long-term benzodiazepine therapy: effects on withdrawal symptoms and taper outcome

Is There a Rationale for Prescription of Benzodiazepines in the Elderly? Review of the Literature

Anticonvulsant Agents for the Management of Benzodiazepine Dependence

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