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A physician's guide to discontinuing benzodiazepine therapy
1Institute for Behavior and Health, Rockville, Md 20852.
The Western Journal of Medicine
|May 1, 1990
Summary
Physicians can help patients discontinue benzodiazepines using dose reduction, switching to longer-acting medications, or symptom-suppressing drugs. Specialized care and aftercare are crucial for long-term users and those with chemical dependency.
Area of Science:
- Pharmacology and Addiction Medicine
- Clinical Therapeutics
Background:
- Benzodiazepine dependence is a significant clinical challenge.
- Physicians require practical strategies for benzodiazepine discontinuation.
- Existing methods may not be sufficient for all patient populations.
Purpose of the Study:
- To present practical techniques for benzodiazepine cessation.
- To outline alternative strategies for difficult-to-manage cases.
- To emphasize the importance of aftercare in benzodiazepine discontinuation.
Main Methods:
- Gradual dose reduction as the primary approach.
- Alternative strategies: switching to longer-acting medications (e.g., clonazepam, phenobarbital) or using symptom-suppressing medications (e.g., carbamazepine, propranolol, clonidine).
- Inpatient detoxification for refractory cases.
- Special considerations for chemically dependent patients and alcohol abusers.
Main Results:
- Gradual dose reduction is widely applicable and often successful.
- Cross-tolerance with longer-acting agents or symptom suppression can aid discontinuation.
- Inpatient detoxification serves as a final option.
- Tailored approaches are necessary for complex patient profiles.
Conclusions:
- A stepwise approach to benzodiazepine discontinuation is effective.
- Medication management and specialized care improve cessation outcomes.
- Comprehensive aftercare is essential for sustained sobriety and patient well-being.