title: Clinical aspects of chronic use of alprazolam and lorazepam.
abstract: OBJECTIVE
  The authors' goal was to determine the clinical characteristics of persistent users of alprazolam or lorazepam who wished to discontinue their medication.
  
  
  METHODS
  Long-term users (daily use for more than 3 months) of alprazolam (N = 34) or lorazepam (N = 97) who entered an outpatient treatment program for discontinuation of benzodiazepines were carefully assessed. Detailed histories of benzodiazepine use were obtained; a structured interview was used to make psychiatric diagnoses based on DSM-III-R criteria.
  
  
  RESULTS
  The majority of patients were using low therapeutic doses of medication (lorazepam: mean = 2.7 mg/day; alprazolam: mean = 1.2 mg/day) and had either maintained their initial daily dose over time or decreased it. Individuals tended to shift their use of medication from an as-prescribed to an as-needed pattern. Forty-seven percent of the patients were diagnosed with at least one current anxiety disorder, most commonly generalized anxiety. At least one diagnosable personality disorder was found in 45% of the patients, most commonly obsessive-compulsive personality disorder. Patterns of benzodiazepine use were influenced by age, gender, and past history of alcohol dependence.
  
  
  CONCLUSIONS
  Long-term users of alprazolam/lorazepam seeking treatment for discontinuation had clinically important past and current psychiatric histories. They used a constant or decreasing dose of medication and made attempts to stop their use. Persistent use of alprazolam/lorazepam for therapeutic purposes did not represent abuse or addiction as the terms are usually understood. A substantial proportion of these patients may be receiving appropriate maintenance therapy for a chronic psychiatric condition.
authors.affiliation: Clinical Research and Treatment Institute, Addiction Research Foundation, Toronto, Ont., Canada.
authors.forename: M
authors.initials: M
authors.lastname: Romach
authors.forename: U
authors.initials: U
authors.lastname: Busto
authors.forename: G
authors.initials: G
authors.lastname: Somer
authors.forename: H L
authors.initials: HL
authors.lastname: Kaplan
authors.forename: E
authors.initials: E
authors.lastname: Sellers
mesh_terms: D000525:Alprazolam / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000553:Ambulatory Care; D001008:Anxiety Disorders / Q000188:drug therapy; D003866:Depressive Disorder / Q000188:drug therapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008140:Lorazepam / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D013375:Substance Withdrawal Syndrome / Q000453:epidemiology / Q000209:etiology; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology
chemical_list: D008140:Lorazepam; D000525:Alprazolam