title: In-patient benzodiazepine withdrawal: comparison of fixed and symptom-triggered taper methods.
abstract: Fixed and symptom-triggered taper methods during in-patient benzodiazepine withdrawal treatment were compared using a randomized controlled design. Forty-four benzodiazepine users seeking in-patient withdrawal treatment at two substance use treatment clinics in Adelaide, Australia were recruited. Measurements included the Severity of Dependence Scale and the SF-36. A scale comprising six items from the Clinical Institute Withdrawal Assessment Scale--Benzodiazepines (CIWA-B) was used to measure withdrawal symptoms. Participants were randomized to receive a fixed diazepam tapering regime or diazepam only in response to withdrawal symptoms (symptom-triggered group). Results showed that there were no significant differences between treatment groups in terms of withdrawal severity, duration of in-patient treatment, amount of diazepam administered, treatment attrition and benzodiazepine use at follow-up. Both groups showed a reduction in benzodiazepine dosage of 86% over the first 8 days which was maintained at 1 month post-discharge. Although there were improvements in some subscales of the SF-36 between baseline and follow-up, values were significantly below age-matched norms at both time-points. This study showed that benzodiazepine users entering treatment have relatively poor health and that symptom-triggered taper methods incorporating flexible dosing and flexible treatment duration are as effective as fixed dose taper methods for in-patient benzodiazepine withdrawal treatment.
authors.affiliation: Drug and Alcohol Services Council, South Australia, Australia.
authors.forename: Catherina
authors.initials: C
authors.lastname: McGregor
authors.forename: Alison
authors.initials: A
authors.lastname: Machin
authors.forename: Jason M
authors.initials: JM
authors.lastname: White
mesh_terms: D000328:Adult; D001569:Benzodiazepines / Q000009:adverse effects*; D003975:Diazepam / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D018757:GABA Modulators / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D012720:Severity of Illness Index; D016320:Substance Abuse Treatment Centers; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D011795:Surveys and Questionnaires
chemical_list: D018757:GABA Modulators; D001569:Benzodiazepines; D003975:Diazepam