title: Efficacy of CBT for benzodiazepine discontinuation in patients with panic disorder: Further evaluation.
abstract: Despite its acute efficacy for the treatment of panic disorder, benzodiazepines (BZs) are associated with a withdrawal syndrome that closely mimics anxiety sensations, leading to difficulty with treatment discontinuation and often disorder relapse. An exposure-based cognitive-behavioral treatment for BZ discontinuation, Panic Control Treatment for BZ Discontinuation (CBT) targets the fear of these sensations and has demonstrated efficacy in preventing disorder relapse and facilitating successful BZ discontinuation among patients with panic disorder. In this randomized controlled trial, CBT was compared to taper alone and a taper plus a relaxation condition to control for the effect of therapist contact and support among 47 patients with panic disorder seeking taper from BZs. Based on the primary outcome of successful discontinuation of BZ use, results indicate that adjunctive CBT provided additive benefits above both taper alone and taper plus relaxation, with consistently medium and large effect sizes over time that reached significance at the six month follow-up evaluation. The efficacy of CBT relative to either of the other taper conditions reflected very large and significant effect sizes at that time. These findings suggest that CBT provides specific efficacy for the successful discontinuation from BZs, even when controlling for therapist contact and relaxation training.
authors.affiliation: Department of Psychology, Boston University, 648 Beacon Street, 5th Floor, Boston, MA 02215, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Otto
authors.forename: R Kathryn
authors.initials: RK
authors.lastname: McHugh
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Simon
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Farach
authors.forename: John J
authors.initials: JJ
authors.lastname: Worthington
authors.forename: Mark H
authors.initials: MH
authors.lastname: Pollack
mesh_terms: D000328:Adult; D000525:Alprazolam / Q000008:administration & dosage / Q000009:adverse effects*; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects*; D002998:Clonazepam / Q000008:administration & dosage / Q000009:adverse effects*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000188:drug therapy*; D012064:Relaxation Therapy / Q000379:methods; D055502:Secondary Prevention; D013375:Substance Withdrawal Syndrome / Q000628:therapy*
chemical_list: D001569:Benzodiazepines; D002998:Clonazepam; D000525:Alprazolam