Benzodiazepines: dependence and a therapeutic approach to gradual withdrawal

The extensive use of benzodiazepines in the treatment of anxiety and insomnia has led clinicians to wonder about the dependence potential of these drugs. It is estimated that, in Canada, the United States, and western Europe, between 10% and 20% of the population take tranquilizers or hypnotics (mainly benzodiazepines). Of these, 70% are 50 years of age or older; 15% have been taking these drugs for more than 12 months. One researcher reported that 50% of patients who received a prescription for benzodiazepines renewed it without consulting their physician. In this article, the authors briefly review the concept of dependence, the risk factors, and the clinical signs of a benzodiazepine withdrawal syndrome. They then develop a rational therapeutic approach to make it easier to discontinue these drugs.