Withdrawing Benzodiazepines in Primary Care

@article{Lader2009WithdrawingBI,
  title={Withdrawing Benzodiazepines in Primary Care},
  author={Malcolm Harold Lader and Andr{\'e} T. Tylee and John Donoghue},
  journal={CNS Drugs},
  year={2009},
  volume={23},
  pages={19-34}
}
The use of benzodiazepine anxiolytics and hypnotics continues to excite controversy. Views differ from expert to expert and from country to country as to the extent of the problem, or even whether long-term benzodiazepine use actually constitutes a problem. The adverse effects of these drugs have been extensively documented and their effectiveness is being increasingly questioned. Discontinuation is usually beneficial as it is followed by improved psychomotor and cognitive functioning… 

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References

SHOWING 1-10 OF 168 REFERENCES

The diagnosis and management of benzodiazepine dependence

  • H. Ashton
  • Medicine, Psychology
    Current opinion in psychiatry
  • 2005
Benzodiazepine dependence could be prevented by adherence to recommendations for short-term prescribing (2–4 weeks only when possible), and withdrawal from dependent patients is feasible and need not be traumatic if judiciously, and often individually, managed.

Current benzodiazepine issues

Reviews of epidemiological, clinical and experimental literature indicated that the previous conclusion about abuse of these drugs still holds: the vast majority of the use of benzodiazepines is appropriate.

Reducing the use of benzodiazepines in general practice

The use of benzodiazepines has fallen steadily since the 1970s, and they are now often regarded as suitable only for short term use, if they have a use at all.

An Approach to Reduce Benzodiazepine and Cyclopyrrolone Use in General Practice

An effective strategy implemented in general practice in Denmark to reduce the use of benzodiazepine and cyclopyrrolone agents, while at the same time challenging practitioners’ ingrained habits and prejudices in this field is described.

Psychological strategies for discontinuing benzodiazepine treatment.

  • D. A. Spiegel
  • Psychology, Medicine
    Journal of clinical psychopharmacology
  • 1999
Cognitive and behavioral techniques such as those developed for the treatment of panic disorder may be especially well-suited for helping patients to discontinue benzodiazepines.

Strategies for discontinuing long-term benzodiazepine use

Evidence was found for the efficacy of stepped care (minimal intervention followed by systematic discontinuation alone) in discontinuing long-term benzodiazepine use in European countries.

History of benzodiazepine dependence.

  • M. Lader
  • Medicine
    Journal of substance abuse treatment
  • 1991

Long term use of hypnotics and anxiolytics May not result in increased tolerance

Evidence is provided that long term prescription of this class of drugs does not necessarily result in increasing tolerance, and patients receiving computerised repeat prescriptions of hypnotic and anxiolytic drugs in Haddington, Lothian region in 1992 were identified.

EVALUATION OF PROGRAMS FOR THE TREATMENT OF BENZODIAZEPINE DEPENDENCY

To achieve more reliable and valid evaluations it is necessary to get data which describe the process and the results from both the clients' and the therapists' perspectives and combining different research strategies.

Older adults and withdrawal from benzodiazepine hypnotics in general practice: effects on cognitive function, sleep, mood and quality of life

Findings suggest that, taken long-term, BZDs do not aid sleep and produces some subtle cognitive advantages for older people, yet little in the way of withdrawal symptoms or emergent sleep difficulties.
...