Long-term therapeutic use of benzodiazepines. II. Effects of gradual taper

Arch Gen Psychiatry. 1990 Oct;47(10):908-15. doi: 10.1001/archpsyc.1990.01810220024003.

Abstract

We compared the effect on withdrawal severity and acute outcome of a 25% per week taper of short half-life vs long half-life benzodiazepines in 63 benzodiazepine-dependent patients. Patients unable to tolerate taper were permitted to slow the taper rate. Ninety percent of patients experienced a withdrawal reaction, but it was rarely more than mild to moderate. Nonetheless, 32% of long half-life and 42% of short half-life benzodiazepine-treated patients were unable to achieve a drug-free state. The most difficulty was experienced in the last half of taper. Baseline personality, high Eysenck neuroticism, female sex, and mild-to-moderate alcohol use were found to be more significant predictors of withdrawal severity than the daily benzodiazepine dose or benzodiazepine half-life. These findings suggest that personality factors contribute significantly to the patient's difficulties with gradual benzodiazepine discontinuation of therapeutic doses of benzodiazepines.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Anxiety Disorders / drug therapy*
  • Anxiety Disorders / psychology
  • Benzodiazepines / administration & dosage
  • Benzodiazepines / adverse effects*
  • Benzodiazepines / metabolism
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / psychology
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Half-Life
  • Humans
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Panic
  • Patient Compliance
  • Personality Inventory
  • Probability
  • Substance Withdrawal Syndrome / diagnosis
  • Substance Withdrawal Syndrome / etiology*
  • Substance Withdrawal Syndrome / prevention & control
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / etiology

Substances

  • Benzodiazepines