Author:
Zitman Frans G.,Couvée Jaap E.
Abstract
BackgroundMany patients with depression take benzodiazepine drugs long term despite the absence of continuing therapeutic value.AimsTo evaluate a treatment programme involving gradual discontinuation with or without simultaneous selective serotonin reuptake inhibitor (SSRI) prescribing and to determine the long-term outcome after benzodiazepine withdrawal.MethodPatients went through three phases – change to an equivalent dose of diazepam; subsequent randomisation to either 20 mg of paroxetine or placebo; and gradual reduction of diazepam in depression-free patients – with a follow-up after 2 or 3 years.ResultsA total of 230 patients were recruited and 75% in the paroxetine group and 61% in the placebo group were successfully treated after 6 weeks (P=0.067). After 2 or 3 years 13% of patients were still benzodiazepine free: 26% of those who had successfully tapered off benzodiazepine and 6% of the total group.ConclusionsTransfer to diazepam followed by gradual withdrawal is an effective way of discontinuing chronic benzodiazepine use. The addition of SSRI treatment is of limited value.
Publisher
Royal College of Psychiatrists
Subject
Psychiatry and Mental health
Cited by
73 articles.
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