Tapering off long-term benzodiazepine use with or without group cognitive-behavioural therapy: three-condition, randomised controlled trial.
BACKGROUND
Benzodiazepine withdrawal programmes have never been experimentally compared with a nonintervention control condition.


OBJECTIVE
To evaluate the efficacy and feasibility of tapering off long-term benzodiazepine use in general practice, and to evaluate the value of additional group cognitive-behavioural therapy (CBT).


METHODS
A 3-month randomised, 3-month controlled trial was conducted in which 180 people attempting to discontinue long-term benzodiazepine use were assigned to tapering off plus group CBT, tapering off alone or usual care.


RESULTS
Tapering off led to a significantly higher proportion of successful discontinuations than usual care (62% nu. 21%). Adding group CBT did not increase the success rate (58% v. 62%). Neither successful discontinuation nor intervention type affected psychological functioning. Both tapering strategies showed good feasibilityin general practice.


CONCLUSIONS
Tapering off is a feasible and effective way of discontinuing long-term benzodiazepine use in general practice. The addition of group CBT is of limited value.
Voshaar
R C Oude
RC
University Medical Centre, Nijmegen, The Netherlands. r.oudevoshaar@psy.umcn.nl
Gorgels
W J M J
WJ
Mol
A J J
AJ
van Balkom
A J L M
AJ
van de Lisdonk
E H
EH
Breteler
M H M
MH
van den Hoogen
H J M
HJ
Zitman
F G
FG
D000368:Aged; D000704:Analysis of Variance; D014151:Anti-Anxiety Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001291:Attitude of Health Personnel; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy / Q000379:methods; D003975:Diazepam / Q000627:therapeutic use; D005194:Family Practice; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017060:Patient Satisfaction; D011615:Psychotherapy, Group; D013375:Substance Withdrawal Syndrome / Q000209:etiology
D014151:Anti-Anxiety Agents; D003975:Diazepam