Predictors of Benzodiazepine Discontinuation in Subjects Manifesting Complicated Dependence

  title={Predictors of Benzodiazepine Discontinuation in Subjects Manifesting Complicated Dependence},
  author={Helena Vorma and Hannu Naukkarinen and Seppo Sarna and Kimmo Kuoppasalmi},
  journal={Substance Use \& Misuse},
  pages={499 - 510}
We described characteristics of subjects with benzodiazepine dependence that was typically complicated by harmful and hazardous alcohol use or high benzodiazepine doses, and assessed predictors of successful discontinuation of benzodiazepines for this group. Seventy-six patients who participated in a randomized clinical trial of two different gradual withdrawal treatment approaches were assessed. The trial was conducted between February 1995 and July 1999. The mean age ±SD of subjects was 40.0… 

Adjunctive benzodiazepine treatment of hospitalized schizophrenia patients in Asia from 2001 to 2008.

Critical clinical guidelines should be developed specifically for Asian countries to address sound practices in regard to use of benzodiazepines for psychotic disorders.

Psychosocial interventions for benzodiazepine harmful use, abuse or dependence.

There was moderate quality of evidence that CBT plus taper was more likely to result in successful discontinuation of BZDs within four weeks post treatment compared to taper only, and there was very low quality evidence for the effect on drop-outs at any of the time intervals.

Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for the Discontinuation of Long-Term Benzodiazepine Use in Insomnia and Anxiety Disorders

Traditional and novel CBT techniques in this regard, such as Acceptance and Commitment Therapy, which address both the underlying condition (insomnia/anxiety) and the substance-related disorder are examined, which are shown to increase abstinence success to 70–80%.

Benzodiazepines: Uses, Dangers, and Clinical Considerations.

The dependence on BZDs generally leads to withdrawal symptoms, requiring careful tapering of the medication when prescribed, and many drugs have been tested as a treatment for withdrawal, with few proving efficacious in randomized control trials.

Collaborative Deprescribing in Borderline Personality Disorder: A Narrative Review

A narrative review of medication management in borderline personality disorder (BPD), using a single vignette to explore the limitations of prescribing multiple medications and the factors contributing to polypharmacy, and describes how medication regimens can be reduced to a necessary minimum.

Borderline Personality Disorder, Atypical Depression, and Cyclothymia: Diagnostic Distinctions Crossing Mood and Personality Disorders Borders

In clinical presentations where all three diagnoses are possible, a combined approach utilizing psychotherapy to stabilize interpersonal sensitivities and affective instability with adjunctive mood stabilizing agents may optimize the long-term outcomes for this chronic and functionally challenged group of patients.

An electronic intervention to improve safety for pain patients co-prescribed chronic opioids and benzodiazepines

Electronic interventions may provide an effective strategy to improve safety for patients co-prescribed chronic opioids for pain and benzodiazepines at 3 and 6 months.

Suchtpotenzial und andere Risiken von Benzodiazepinen und Z-Drugs im Alter

Zusammenfassung. Zielsetzung: Ubersicht uber Suchtpotenzial und andere Risiken von Benzodiazepinen (BZD) und Z-Drugs sowie die Behandlung der Abhangigkeit von diesen Substanzen im Alter. Methodik:

Kurzinterventionen bei Medikamentenabhängigen

Proactive patient recruitment is likely to improve DPD care and the study results might be able to provide a basis for implementing interventions for persons with DPD in a general hospital.



Long-term outcome after benzodiazepine withdrawal treatment in subjects with complicated dependence.

Long-term therapeutic use of benzodiazepines. I. Effects of abrupt discontinuation.

A short half-life and higher daily doses were associated with greater withdrawal severity, as were personality traits, such as dependency and neuroticism, less education and higher baseline levels of anxious and depressive symptoms.

Clinical aspects of chronic use of alprazolam and lorazepam.

Persistent use of alprazolam/lorazepam for therapeutic purposes did not represent abuse or addiction as the terms are usually understood, and a substantial proportion of these patients may be receiving appropriate maintenance therapy for a chronic psychiatric condition.

Treatment of out-patients with complicated benzodiazepine dependence: comparison of two approaches.

A randomized, controlled clinical trial to evaluate whether gradual benzodiazepine taper combined with cognitive-behavioural treatment is more effective than standard treatment for patients with dependence in out-patient clinics for alcohol and drug abusers.

Benzodiazepine use and anxiolytic abuse and dependence in treated alcoholics.

  • H. Ross
  • Psychology, Medicine
  • 1993
Patients with antisocial personality disorder (ASPD) were at higher risk for an anxiolytic disorder as were women and the unemployed as well as recent users of benzodiazepines, who were more likely to have a lifetime DSM-III anxiety disorder.

Benzodiazepine withdrawal: outcome in 50 patients.

  • H. Ashton
  • Psychology, Medicine
    British journal of addiction
  • 1987
Clinical outcome was assessed in SO consecutive patients who completed a course of supervized benzodiazepine withdrawal following referral to a Clinical Pharmacology Unit, finding that younger age was significantly associated with a favourable outcome, but outcome was not related to duration or dosage of Benzodiazepines.

Benzodiazepine abuse and dependence in psychiatric inpatients.

Over a period of five and a half years, 792 inpatients with benzodiazepine abuse and dependence in accordance with the WHO definition were registered at a university psychiatric hospital, and it was possible to distinguish two groups of patients: one with primary, mainly low- dose, dependence preferring lorazepam and the other with secondary, often high-dose, dependence with diazepam as the main drug.

The effect of personality on withdrawal severity and taper outcome in benzodiazepine dependent patients

Clinical decisions on how to manage BZ tapering should be guided by personality assessments, in addition to the usual considerations of BZ dosage, residual psychopathology, duration of treatment, etc.

Multiple drug use and psychiatric comorbidity in patients admitted to the hospital with severe benzodiazepine dependence.

It is demonstrated that in patients severely dependent on benzodiazepines, additional psychoactive substance use and mental disorders are prominent, and the pattern of drug use and psychiatric comorbidity differentiates these patients from therapeutic-dose Benzodiazepine users.

Imipramine and buspirone in treatment of patients with generalized anxiety disorder who are discontinuing long-term benzodiazepine therapy.

Management of benzodiazepine discontinuation can be facilitated significantly by co-prescribing imipramine before and during the benzodiazine taper, and the imipramsine effect remained highly significant even after the analysis adjusted for three other independent predictors of taper success.