Author:
Voshaar Richard C. Oude,Couvée Jaap E.,Van Balkom Anton J. L. M.,Mulder Paul G. H.,Zitman Frans G.
Abstract
BackgroundThe prevalence of benzodiazepine consumption in European countries
remains at 2–3% of the general population despite the well-documented
disadvantages of long-term use.AimsTo review systematically the success rates of different benzodiazepine
discontinuation strategies.MethodMeta-analysis of comparable intervention studies.ResultsTwenty-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.ConclusionsEvidence was found for the efficacy of stepped care (minimal intervention
followed by systematic discontinuation alone) in discontinuing long-term
benzodiazepine use.
Publisher
Royal College of Psychiatrists
Subject
Psychiatry and Mental health
Cited by
163 articles.
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