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Strategies for discontinuing long-term benzodiazepine use: Meta-analysis

  • Richard C. Oude Voshaar (a1), Jaap E. Couvée (a2), Anton J. L. M. Van Balkom (a3), Paul G. H. Mulder (a4) and Frans G. Zitman (a5)...

Abstract

Background

The prevalence of benzodiazepine consumption in European countries remains at 2–3% of the general population despite the well-documented disadvantages of long-term use.

Aims

To review systematically the success rates of different benzodiazepine discontinuation strategies.

Method

Meta-analysis of comparable intervention studies.

Results

Twenty-nine articles met inclusion criteria. Two groups of interventions were identified; minimal intervention (e.g. giving simple advice in the form of a letter or meeting to a large group of people; n=3), and systematic discontinuation (defined as treatment programmes led by a physician or psychologist; n=26). Both were found to be significantly more effective than treatment as usual: minimal interventions (pooled OR=2.8, 95% CI 1.6–5.1); systematic discontinuation alone (one study, OR=6.1, 95% CI 2.0–18.6). Augmentation of systematic discontinuation with imipramine (two studies, OR=3.1, 95% CI 1.1–9.4) or group cognitive-behavioural therapy for patients with insomnia (two studies, OR=5.5, 95% CI 2.3–14.2) was superior to systematic discontinuation alone.

Conclusions

Evidence was found for the efficacy of stepped care (minimal intervention followed by systematic discontinuation alone) in discontinuing long-term benzodiazepine use.

Copyright

Corresponding author

Dr J. E. Couvée, Head Clinical Development CNS, Anti-Infectives and Oncology, GlaxoSmith Kline, Medical Department, Huis ter Heideweg 62, 3705 LZ Zeist, The Netherlands. Tel: +31 30 6938145; fax: +31 30 6938459; email: jaap.e.couvee@gsk.com

Footnotes

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Declaration of interest

None.

Footnotes

References

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Strategies for discontinuing long-term benzodiazepine use: Meta-analysis

  • Richard C. Oude Voshaar (a1), Jaap E. Couvée (a2), Anton J. L. M. Van Balkom (a3), Paul G. H. Mulder (a4) and Frans G. Zitman (a5)...
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