Long-term therapeutic use of benzodiazepines. II. Effects of gradual taper.
We compared the effect on withdrawal severity and acute outcome of a 25% per week taper of short half-life vs long half-life benzodiazepines in 63 benzodiazepine-dependent patients. Patients unable to tolerate taper were permitted to slow the taper rate. Ninety percent of patients experienced a withdrawal reaction, but it was rarely more than mild to moderate. Nonetheless, 32% of long half-life and 42% of short half-life benzodiazepine-treated patients were unable to achieve a drug-free state. The most difficulty was experienced in the last half of taper. Baseline personality, high Eysenck neuroticism, female sex, and mild-to-moderate alcohol use were found to be more significant predictors of withdrawal severity than the daily benzodiazepine dose or benzodiazepine half-life. These findings suggest that personality factors contribute significantly to the patient's difficulties with gradual benzodiazepine discontinuation of therapeutic doses of benzodiazepines.
Schweizer
E
E
Department of Psychiatry, University of Pennsylvania, Philadelphia.
Rickels
K
K
Case
W G
WG
Greenblatt
D J
DJ
D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000523:psychology; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects* / Q000378:metabolism; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006207:Half-Life; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010200:Panic; D010349:Patient Compliance; D010555:Personality Inventory; D011336:Probability; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000209:etiology
D001569:Benzodiazepines