Skip to main content

Interventions for reducing benzodiazepine use in older people: meta-analysis of randomised controlled trials

  • Rebecca L. Gould (a1), Mark C. Coulson (a2), Natasha Patel (a3), Elizabeth Highton-Williamson (a3) and Robert J. Howard (a3)...

The use of benzodiazepines has been advised against in older people, but prevalence rates remain high.


To review the evidence for interventions aimed at reducing benzodiazepine use in older people.


We conducted a systematic review, assessment of risk of bias and meta-analyses of randomised controlled trials of benzodiazepine withdrawal and prescribing interventions.


Ten withdrawal and eight prescribing studies met the inclusion criteria. At post-intervention, significantly higher odds of not using benzodiazepines were found with supervised withdrawal with psychotherapy (odds ratio (OR) = 5.06, 95% CI 2.68–9.57, P<0.00001) and withdrawal with prescribing interventions (OR = 1.43, 95% CI 1.02–2.02, P=0.04) in comparison with the control interventions treatment as usual (TAU), education placebo, withdrawal with or without drug placebo, or psychotherapy alone. Significantly higher odds of not using benzodiazepines were also found for multifaceted prescribing interventions (OR = 1.37, 95% CI 1.10–1.72, P = 0.006) in comparison with control interventions (TAU and prescribing placebo).


Supervised benzodiazepine withdrawal augmented with psychotherapy should be considered in older people, although pragmatic reasons may necessitate consideration of other strategies such as medication review.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Interventions for reducing benzodiazepine use in older people: meta-analysis of randomised controlled trials
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Interventions for reducing benzodiazepine use in older people: meta-analysis of randomised controlled trials
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Interventions for reducing benzodiazepine use in older people: meta-analysis of randomised controlled trials
      Available formats
Corresponding author
Dr Rebecca Gould, Department of Old Age Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email:
Hide All

This research was supported by the Mental Health of Older Adults and Dementia Clinical Academic Group within King's Health Partners Academic Health Sciences Centre at the Institute of Psychiatry, King's College London and the South London and Maudsley National Health Service Foundation Trust.

Declaration of interest


Hide All
1 Beers, MH, Ouslander, JG, Rollingher, I, Reuben, DB, Brooks, J, Beck, JC. Explicit criteria for determining inappropriate medication use in nursing-home residents. Arch Intern Med 1991; 151: 1825–32.
2 Fick, DM, Cooper, JW, Wade, WE, Waller, JL, Maclean, JR, Beers, MH. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med 2003; 163: 2716–24.
3 Ashton, CH. The Ashton Manual. Benzodiazepines: How They Work and How to Withdraw. 2002.
4 Department of Health. Benzodiazepines warning. In Chief Medical Officer's Update 37, Patient Safety. Department of Health, 2004.
5 Buffett-Jerrott, SE, Stewart, SH. Cognitive and sedative effects of benzodiazepine use. Curr Pharm Des 2002; 8: 4558.
6 Hill, KD, Wee, R. Psychotropic drug-induced falls in older people: a review of interventions aimed at reducing the problem. Drugs Aging 2012; 29: 1530.
7 Cumming, RG, Le Couteur, DG. Benzodiazepines and risk of hip fractures in older people: a review of the evidence. CNS Drugs 2003; 17: 825–37.
8 Meuleners, LB, Duke, J, Lee, AH, Palamara, P, Hildebrand, J, Ng, JQ. Psychoactive medications and crash involvement requiring hospitalization for older drivers: a population-based study. J Am Geriatr Soc 2011; 59: 1575–80.
9 Clegg, A, Young, JB. Which medications to avoid in people at risk of delirium: a systematic review. Age Ageing 2011; 40: 23–9.
10 Voyer, P, Preville, M, Martin, LS, Roussel, ME, Beland, SG, Berbiche, D. Factors associated with self-rated benzodiazepine addiction among community-dwelling seniors. J Addict Nurs 2011; 22: 4656.
11 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2012; 60: 616–31.
12 Johnell, K, Fastbom, J. The use of benzodiazepines and related drugs amongst older people in Sweden: associated factors and concomitant use of other psychotropics. Int J Geriatr Psychiatry 2009; 24: 731–8.
13 Dionne, PA, Vasiliadis, HM, Latimer, E, Berbiche, D, Preville, M. Economic impact of inappropriate benzodiazepine prescribing and related drug interactions among elderly persons. Psychiatr Serv 2013; 64: 331–8.
14 Martinsson, G, Fagerberg, I, Wiklund-Gustin, L, Lindholm, C. Specialist prescribing of psychotropic drugs to older persons in Sweden – a register-based study of 188 024 older persons. BMC Psychiatry 2012; 12: 197.
15 Preville, M, Vasiliadis, HM, Bosse, C, Dionne, PA, Voyer, P, Brassard, J, et al. Pattern of psychotropic drug use among older adults having a depression or an anxiety disorder: Results from the longitudinal ESA study. Can J Psychiatry 2011; 56: 348–57.
16 Lasserre, A, Younes, N, Blanchon, T, Cantegreil-Kallen, I, Passerieux, C, Thomas, G, et al. Psychotropic drug use among older people in general practice: discrepancies between opinion and practice. Br J Gen Pract 2010; 60: 156–62.
17 Russell, J, Lader, M. Guidelines for the Prevention and Treatment of Benzodiazepine Dependence. Mental Health Foundation, 1993.
18 Parr, JM, Kavanagh, DJ, Cahill, L, Mitchell, G, Young, RM. Effectiveness of current treatment approaches for benzodiazepine discontinuation: a meta-analysis. Addiction 2008; 104: 1324.
19 Mugunthan, K, McGuire, T, Glasziou, P. Minimal interventions to decrease long-term use of benzodiazepines in primary care: a systematic review and meta-analysis. Br J Gen Pract 2011; 61: 573–8.
20 Oude Voshaar, RC, Couvée, JE, Van, Balkom AJLM, Mulder, PGH, Zitman, FG. Strategies for discontinuing long-term benzodiazepine use. Meta-analysis. Br J Psychiatry 2006; 189: 213–20.
21 Denis, C, Fatseas, M, Lavie, E, Auriacombe, M. Pharmacological interventions for benzodiazepine mono-dependence management in outpatient settings. Cochrane Database Syst Rev 2006; 3: CD005194.
22 Milton, JC, Hill-Smith, I, Jackson, SHD. Prescribing for older people. BMJ 2008; 336: 606–9.
23 Forsetlund, L, Eike, MC, Gjerberg, E, Vist, GE. Effect of interventions to reduce potentially inappropriate use of drugs in nursing homes: a systematic review of randomised controlled trials. BMC Geriatr 2011; 11: 16.
24 Nishtala, PS, McLachlan, AJ, Bell, JS, Chen, TF. Psychotropic prescribing in long-term care facilities: impact of medication reviews and educational interventions. Am J Geriatr Psychiatry 2008; 16: 621–32.
25 Smith, AJ, Tett, SE. Improving the use of benzodiazepines – is it possible? A non-systematic review of interventions tried in the last 20 years. BMC Health Serv Res 2010; 10: 321.
26 Marcum, ZA, Handler, SM, Wright, R, Hanlon, JT. Interventions to improve suboptimal prescribing in nursing homes: a narrative review. Am J Geriatr Pharmacother 2010; 8: 183200.
27 Ostini, R, Jackson, C, Hegney, D, Tett, SE. How is medication prescribing ceased? A systematic review. Med Care 2011; 49: 2436.
28 Cantopher, T, Olivieri, S, Cleave, N, Edwards, JG. Chronic benzodiazepine dependence. A comparative study of abrupt withdrawal under propranolol cover versus gradual withdrawal. Br J Psychiatry 1990; 156: 406–11.
29 Cormack, MA, Sweeney, KG, Hughesjones, H, Foot, GA. Evaluation of an easy, cost-effective strategy for cutting benzodiazepine use in general practice. Br J Gen Pract 1994; 44: 58.
30 Schweizer, E, Rickels, K, De Martinis, N, Case, G, Garcia-Espana, F. The effect of personality on withdrawal severity and taper outcome in benzodiazepine dependent patients. Psychol Med 1998; 28: 713–20.
31 Schweizer, E, Case, WG, Rickels, K. Benzodiazepine dependence and withdrawal in elderly patients. Am J Psychiatry 1989; 146: 529–31.
32 Ashton, H. Benzodiazepine withdrawal – outcome in 50 patients. Br J Addict 1987; 82: 665–71.
33 Holden, JD, Hughes, IM, Tree, A. Benzodiazepine prescribing and withdrawal for 3234 patients in 15 general practices. Fam Pract 1994; 11: 358–62.
34 Lemoine, P, Kermadi, I, Garcia-Acosta, S, Garay, RP, Dib, M. Double-blind, comparative study of cyamemazine vs. bromazepam in the benzodiazepine withdrawal syndrome. Prog Neuropsychopharmacol Biol Psychiatry 2006; 30: 131–7.
35 Rickels, K, Case, WG, Schweizer, E, Garciaespana, F, Fridman, R. Long-term benzodiazepine users 3 years after participation in a discontinuation program. Am J Psychiatry 1991; 148: 757–61.
36 Gorgels, W, Oude Voshaar, RC, Mol, AJJ, van de Lisdonk, EH, van Balkom, A, Breteler, MHM, et al. Predictors of discontinuation of benzodiazepine prescription after sending a letter to long-term benzodiazepine users in family practice. Fam Pract 2006; 23: 6572.
37 Oude Voshaar, RC, Gorgels, WJMJ, Mol, AJJ, Van, Balkom AJLM, Van, de Lisdonk EH, Breteler, MHM, et al. Tapering off long-term benzodiazepine use with or without group cognitive–behavioural therapy: three-condition, randomised controlled trial. Br J Psychiatry 2003; 182: 498504.
38 Schweizer, E, Rickels, K, Case, WG, Greenblatt, DJ. Long-term therapeutic use of benzodiazepines II. Effects of gradual taper. Arch Gen Psychiatry 1990; 47: 908–15.
39 Smith, DH, Christensen, DB, Stergachis, A, Holmes, G. A randomized controlled trial of a drug use review intervention for sedative hypnotic medications. Med Care 1998; 36: 1013–21.
40 Stewart, R, Niessen, WJM, Broer, J, Snijders, TAB, Haaijer-Ruskamp, FM, Jong, BMD. General practitioners reduced benzodiazepine prescriptions in an intervention study: a multilevel application. J Clin Epidemiol 2007; 60: 1076–84.
41 Ten Wolde, GB, Dijkstra, A, Van Empelen, P, van den Hout, W, Neven, AK, Zitman, F. Long-term effectiveness of computer-generated tailored patient education on benzodiazepines: a randomized controlled trial. Addiction 2008; 103: 662–70.
42 Tyrer, P, Owen, R, Dawling, S. Gradual withdrawal of diazepam after long-term therapy. Lancet 1983; 1: 1402–6.
43 Foy, A, Drinkwater, V, March, S, Mearrick, P. Confusion after admission to hospital in elderly patients using benzodiazepines. BMJ 1986; 293: 1072.
44 Cormack, MA, Sinnott, A. Psychological alternatives to long-term benzodiazepine use. J R Coll Gen Pract 1983; 33: 279–81.
45 Covin, R, Ouimet, AJ, Seeds, PM, Dozois, DJ. A meta-analysis of CBT for pathological worry among clients with GAD. J Anxiety Disord 2008; 22: 108–16.
46 Department of Health. National Service Framework for Older People. Department of Health, 2001.
47 United Nations. World Economic and Social Survey. UN, 2007 (
48 Woods, JH, Katz, JL, Winger, GD. Benzodiazepines: use, abuse, and consequences. Pharmacol Rev 1992; 44: 151347.
49 Higgins, JPT, Altman, DG, Sterne, JAC. Chapter 8: Assessing risk of bias in included studies. In Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0) (eds Higgins, JPT, Green, S). The Cochrane Collaboration, 2011.
50 Higgins, JPT, Green, S. Cochrane Handbook for Systematic Reviews of Interventions, version 5.1.0. Cochrane Collaboration, 2011 (
51 Donner, A, Klar, N. Issues in the meta-analysis of cluster randomized trials. Stat Med 2002; 21: 2971–80.
52 Elbourne, DR, Altman, DG, Higgins, JPT, Curtin, F, Worthington, HV, Vail, A. Meta-analyses involving cross-over trials: methodological issues. Int J Epidemiol 2002; 31: 140–9.
53 StataCorp. Stata Statistical Software: Release 11.2. StataCorp, 2011.
54 Cochrane Collaboration. Review Manager (RevMan) [computer program]. Version 5.1. Nordic Cochrane Centre, Cochrane Collaboration, 2012.
55 Higgins, JPT, Thompson, SG, Deeks, JJ, Altman, DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557–60.
56 Riley, RD, Higgins, JPT, Deeks, JJ. Interpretation of random effects meta-analyses. BMJ 2011; 342: 549.
57 Egger, M, Smith, GD, Schneider, M, Minder, C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629–34.
58 Duval, S, Tweedie, R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 2000; 56: 455–63.
59 Borenstein, M, Hedges, LV, Higgins, JPT, Rothstein, HR. Introduction to Meta-Analysis. Wiley, 2009.
60 Nakanishi, Y, Toyoizumi, S, Nakajima, A, Hamada, C. Subgroup analysis in meta-analysis: a comparison of different methods. Jpn J Pharmacoepidemiol 2007; 12: 1324.
61 Higgins, JPT, Thompson, SG. Controlling the risk of spurious findings from meta-regression. Stat Med 2004; 23: 1663–82.
62 Moher, D, Liberati, A, Tetzlaff, J, Altman, DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009; 339: 2535.
63 Baillargeon, L, Landreville, P, Verreault, R, Beauchemin, JP, Gregoire, JP, Morin, CM. Discontinuation of benzodiazepines among older insomniac adults treated with cognitive-behavioural therapy combined with gradual tapering: a randomized trial. CMAJ 2003; 169: 1015–20.
64 Cardinali, DP, Gvozdenovich, E, Kaplan, MR, Fainstein, I, Shifis, HA, Lloret, SP, et al. A double blind–placebo controlled study on melatonin efficacy to reduce anxiolytic benzodiazepine use in the elderly. Neuro Endocrinol Lett 2002; 23: 5560.
65 Di Costanzo, E, Rovea, A. The prophylaxis of benzodiazepine withdrawal syndrome in the elderly: the effectiveness of carbamazepine. Double-blind study vs. placebo. Minerva Psichiatr 1992; 33: 301–4.
66 Giblin, MJ, Clift, AD. Sleep without drugs. J R Coll Gen Pract 1983; 33: 628–33.
67 Habraken, H, Soenen, K, Blondeel, L, VanElsen, J, Bourda, J, Coppens, E, et al. Gradual withdrawal from benzodiazepines in residents of homes for the elderly: experience and suggestions for future research. Eur J Clin Pharmacol 1997; 51: 355–8.
68 Morin, CM, Bastien, C, Guay, B, Radouco-Thomas, M, Leblanc, J, Vallieres, A. Randomized clinical trial of supervised tapering and cognitive behavior therapy to facilitate benzodiazepine discontinuation in older adults with chronic insomnia. Am J Psychiatry 2004; 161: 332–42.
69 Petrovic, M, Pevernagie, D, Mariman, A, Van, Maele G, Afschrift, M. Fast withdrawal from benzodiazepines in geriatric inpatients: a randomised double-blind, placebo-controlled trial. Eur J Clin Pharmacol 2002; 57: 759–64.
70 Salonoja, M, Salminen, M, Aarnio, P, Vahlberg, T, Kivela, SL. One-time counselling decreases the use of benzodiazepines and related drugs among community-dwelling older persons. Age Ageing 2010; 39: 313–9.
71 Tham, TCK, Brown, H, Taggart, HM. Temazepam withdrawal in elderly hospitalized patients – a double-blind randomized trial comparing abrupt versus gradual withdrawal. Ir J Med Sci 1989; 158: 294–9.
72 Velert Vila, J. Intervención Farmacéutica para la Adecuación de la Prescripción de Benzodiazepinas en Pacientes Mayores [Pharmaceutical Intervention for the Suitability of Benzodiazepine Prescription in Older Patients]. Cardinal Herrera University, 2011.
73 Velert Vila, J, del, Mar Velert Vila M, Salar, Ibanez L, Avellana, Zaragoza JA, Moreno, Royo L. Adecuación de la utilización de benzodiazepinas en ancianos desde la oficina de farmacia. Un estudio de colaboración médicofarmacéutico [Suitability of the use of benzodiazepines prescribed by the pharmacist in the elderly. A doctor-pharmacist collaboration study]. Aten Primaria 2012; 44: 402–10.
74 Avorn, J, Soumerai, SB, Everitt, DE, Rossdegnan, D, Beers, MH, Sherman, D, et al. A randomized trial of a program to reduce the use of psychoactive drugs in nursing homes. N Engl J Med 1992; 327: 168–73.
75 Crotty, M, Whitehead, C, Rowett, D, Halbert, J, Weller, D, Finucane, P, et al. An outreach intervention to implement evidence based practice in residential care: a randomized controlled trial. BMC Health Serv Res 2004; 4: 6.
76 Pit, SW, Byles, JE, Henry, DA, Holt, L, Hansen, V, Bowman, DA. A Quality Use of Medicines program for general practitioners and older people: a cluster randomised controlled trial. Med J Aust 2007; 187: 2330.
77 Rikala, M, Korhonen, MJ, Sulkava, R, Hartikainen, S. The effects of medication assessment on psychotropic drug use in the community-dwelling elderly. Int Psychogeriatr 2011; 23: 473–84.
78 Roberts, MS, Stokes, JA, King, MA, Lynne, TA, Purdie, DM, Glasziou, PP, et al. Outcomes of a randomized controlled trial of a clinical pharmacy intervention in 52 nursing homes. Br J Clin Pharmacol 2001; 51: 257–65.
79 Strikwerda, P, Bootsma-de, Langen AM, Berghuis, F, Meyboom-de, Jong B. Drug therapy in a nursing home; favorable effect of feedback by the pharmacist on family physician's prescribing behavior. Ned Tijdschr Geneeskd 1994; 138: 1770–4.
80 Oborne, CA, Hooper, R, Swift, CG, Jackson, SHD. Explicit, evidence-based criteria to assess the quality of prescribing to elderly nursing home residents. Age Ageing 2003; 32: 102–8.
81 Thompson, SG, Higgins, JPT. How should meta-regression analyses be undertaken and interpreted? Stat Med 2002; 21: 1559–73.
82 Voyer, P, Preville, M, Cohen, D, Berbiche, D, Beland, SG. The prevalence of benzodiazepine dependence among community-dwelling older adult users in Quebec according to typical and atypical criteria. Can J Aging 2010; 29: 205–13.
83 Oude Voshaar, RC, Gorgels, WJMJ, Mol, AJJ, Van, Balkom AJLM, Mulder, J, Van, de Lisdonk EH, et al. Long-term outcome of two forms of randomised benzodiazepine discontinuation. Br J Psychiatry 2006; 188: 188–9.
84 Dell'osso, B, Lader, M. Do benzodiazepines still deserve a major role in the treatment of psychiatric disorders? A critical reappraisal. Eur Psychiatry 2013; 28: 720.
85 Lader, M, Tylee, A, Donoghue, J. Withdrawing benzodiazepines in primary care. CNS Drugs 2009; 23: 1934.
86 Oude Voshaar, RC, Krabbe, PFM, Gorgels, WJMJ, Adang, EM, van Balkom, AJ, van de Lisdonk, EH, et al. Tapering off benzodiazepines in long-term users: an economic evaluation. Pharmacoeconomics 2006; 24: 683–94.
87 Ostini, R, Hegney, D, Jackson, C, Tett, SE. Knowing how to stop: ceasing prescribing when the medicine is no longer required. J Manag Care Pharm 2012; 18: 6872.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
Type Description Title
Supplementary materials

Gould et al. supplementary material
Supplementary Table S1-S5

 PDF (100 KB)
100 KB


Altmetric attention score

Full text views

Total number of HTML views: 2
Total number of PDF views: 76 *
Loading metrics...

Abstract views

Total abstract views: 440 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 23rd May 2018. This data will be updated every 24 hours.

Interventions for reducing benzodiazepine use in older people: meta-analysis of randomised controlled trials

  • Rebecca L. Gould (a1), Mark C. Coulson (a2), Natasha Patel (a3), Elizabeth Highton-Williamson (a3) and Robert J. Howard (a3)...
Submit a response


Study of Petrovic et al. erroneously classified as 'withdrawal with psychotherapy'

Hilde Habraken, researcher, Farmaka
06 October 2015

I believe there is still an error in the new version of the article.

The study of Petrovic et al. "Fast withdrawal from benzodiazepines in geriatric inpatients: a randomised double-blind, placebo-controlled trial (Eur J Clin Pharmacol. 2002 Jan;57(11):759-64), is included in the subset of studies about 'Withdrawal with psychotherapy'.

Instead it should have been included in the subset of studies about 'Withdrawal with pharmacotherapy'.

This is clear from the study abstract:


We have previously demonstrated that temporary substitution with a low-dose hypnosedative drug may lead to successful withdrawal from chronic benzodiazepine (BZD) use in the majority of patients admitted to a geriatric ward. In the present study, a withdrawal programme was evaluated in which the habitual treatment with BZDs was replaced by either 1 mg lormetazepam or placebo, defining withdrawal success rate, sleep quality and withdrawal symptoms as main outcomes.


The target population was geriatric inpatients who had been taking BZDs for at least 3 months. Subjects suffering from mental disorders were excluded. Lormetazepam or placebo were randomly assigned and given in a double-blind fashion. After 1 week, the replacement therapy was discontinued. Subjective estimations of sleep quality and withdrawal symptoms were registered at predefined intervals, four times in a period of 30 days, using standard questionnaires (the Pittsburgh Sleep Quality Index and the Benzodiazepine Withdrawal Symptom Questionnaire, respectively).


The success rate was significantly higher in the lormetazepam substitution group (80% vs 50% in the placebo group, P < 0.05). Both the subjective quality of sleep and withdrawal symptoms were significantly better in the lormetazepam substitution group. Important withdrawal effects were observed in the control group in two patients with a history of chronic alcohol abuse.


Initial replacement therapy with a low-dose BZD is preferred over placebo, since the latter alternative is associated with worse sleep quality and a lower success rate. Placebo must only be used under medical scrutiny, given the potential for unmasking delirious symptoms, especially in patients with concomitant alcoholism.

It is also clear from the methods section in the full text (p 760): 'The differential effects of lormetazepam versus placebo on withdrawal success rate and symptom scores were the main outcomes of the present study'.

The methods section also states that patients (from both groups) received psychological support if they wished during the study (p. 760, first column):

'Psychological consulting was offered to patients who experienced problems during the withdrawal procedure.'

So I think it is not correct to classify this withdrawal study in the category 'Withdrawal with psychotherapy'. As a consequence the results of the pooled analyses for both the categories 'Withdrawal with pharmacotherapy" and "Withdrawal with psychotherapy" are not correct.

... More

Conflict of interest: None Declared

Write a reply


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *