BACKGROUND: The prevalence of benzodiazepine consumption in European countries remains at 2-3% of the general population despite the well-documented disadvantages of long-term use. AIMS: To review systematically the success rates of different benzodiazepine discontinuation strategies. METHOD: Meta-analysis of comparable intervention studies. RESULTS: Twenty-nine articles met inclusion criteria. Two groups of interventions were identified; minimal intervention (e.g. giving simple advice in the form of a letter or meeting to a large group of people; n=3), and systematic discontinuation (defined as treatment programmes led by a physician or psychologist; n=26). Both were found to be significantly more effective than treatment as usual: minimal interventions (pooled OR=2.8, 95% CI 1.6-5.1); systematic discontinuation alone (one study, OR=6.1, 95% CI 2.0-18.6). Augmentation of systematic discontinuation with imipramine (two studies, OR=3.1, 95% CI 1.1-9.4) or group cognitive-behavioural therapy for patients with insomnia (two studies, OR=5.5, 95% CI 2.3-14.2) was superior to systematic discontinuation alone. CONCLUSIONS: Evidence was found for the efficacy of stepped care (minimal intervention followed by systematic discontinuation alone) in discontinuing long-term benzodiazepine use.
BACKGROUND: The prevalence of benzodiazepine consumption in European countries remains at 2-3% of the general population despite the well-documented disadvantages of long-term use. AIMS: To review systematically the success rates of different benzodiazepine discontinuation strategies. METHOD: Meta-analysis of comparable intervention studies. RESULTS: Twenty-nine articles met inclusion criteria. Two groups of interventions were identified; minimal intervention (e.g. giving simple advice in the form of a letter or meeting to a large group of people; n=3), and systematic discontinuation (defined as treatment programmes led by a physician or psychologist; n=26). Both were found to be significantly more effective than treatment as usual: minimal interventions (pooled OR=2.8, 95% CI 1.6-5.1); systematic discontinuation alone (one study, OR=6.1, 95% CI 2.0-18.6). Augmentation of systematic discontinuation with imipramine (two studies, OR=3.1, 95% CI 1.1-9.4) or group cognitive-behavioural therapy for patients with insomnia (two studies, OR=5.5, 95% CI 2.3-14.2) was superior to systematic discontinuation alone. CONCLUSIONS: Evidence was found for the efficacy of stepped care (minimal intervention followed by systematic discontinuation alone) in discontinuing long-term benzodiazepine use.
Authors: Jason P Caplan; Lucy A Epstein; Davin K Quinn; Jonathan R Stevens; Theodore A Stern Journal: Neuropsychol Rev Date: 2007-08-16 Impact factor: 7.444
Authors: Kevin Pottie; Wade Thompson; Simon Davies; Jean Grenier; Cheryl A Sadowski; Vivian Welch; Anne Holbrook; Cynthia Boyd; Robert Swenson; Andy Ma; Barbara Farrell Journal: Can Fam Physician Date: 2018-05 Impact factor: 3.275
Authors: Kevin Pottie; Wade Thompson; Simon Davies; Jean Grenier; Cheryl A Sadowski; Vivian Welch; Anne Holbrook; Cynthia Boyd; Robert Swenson; Andy Ma; Barbara Farrell Journal: Can Fam Physician Date: 2018-05 Impact factor: 3.275