The long-term outcome of a benzodiazepine discontinuation programme in depressed outpatients.
OBJECTIVE
To assess longitudinally the prescription of psychotropic drugs in depressed patients after they participated in a benzodiazepine discontinuation programme.


METHODS
Two hundred and thirty depressed patients on chronic benzodiazepine therapy took part in a discontinuation programme conducted in 36 general practices. After 2.3 years (S.D.=0.65, range 0.1-3.6) medical records were reviewed.


RESULTS
Follow-up was achieved for 207 (90%) patients. Twenty-five (12%) patients remained benzodiazepine free during the full follow-up period. The majority (n=181, 87%) was prescribed benzodiazepines at an average of 13 (+/-14) mg of diazepam equivalents for 537 (+/-375) days. Fifty-five (74% of 74) of the successfully discontinued patients restarted benzodiazepine therapy. Sixty-eight (33%) patients were prescribed benzodiazepines during the whole follow-up period. Successful taper predicted no or lower subsequent benzodiazepine prescription rates (OR=7.3; 95% CI: 2-16). No influence of GP policy towards benzodiazepine prescription could be detected (P=0.275). Antidepressants were prescribed in 115 (55%) patients for an average duration of 476 (+/-360) days. There was no difference in benzodiazepine prescription (dosage, duration) between patients who had or had not been prescribed an antidepressant.


CONCLUSIONS
Patients were not been diagnosed systematically during the follow-up period.


CONCLUSIONS
If measured longitudinally, the rate of benzodiazepine prescription after discontinuation is much higher than reported in previous studies that have measured this cross-sectionally. Successful discontinuation is a strong predictor of modest or no future benzodiazepine prescription. Two-thirds of patients altered their benzodiazepine usage after taking part in a discontinuation programme. Treatment with antidepressants does not seem to influence benzodiazepine prescription. Patients' request (not GPs'policy) seems to be an important factor in continuing or resuming benzodiazepine prescription.
Medical Department, SmithKline Beecham Farma B.V., P.O. Box 3120, 2280 GC, Rijswijk, The Netherlands. jaap.e.couvee@sb.com
Jaap E
JE
Couvée
Manuela A Y
MA
Timmermans
Frans G
FG
Zitman
D000328:Adult; D001569:Benzodiazepines / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004334:Drug Administration Schedule; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D011619:Psychotropic Drugs; D001569:Benzodiazepines