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Withdrawal from alprazolam dependency using clonazepam: clinical observations
1Psychiatry Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO 65201.
The Journal of Clinical Psychiatry
|May 1, 1990
Summary
Clonazepam substitution safely and effectively discontinued alprazolam dependence in 37 patients, primarily those with posttraumatic stress disorder. This method avoided severe withdrawal syndromes and seizures.
Area of Science:
- Psychiatry
- Clinical Pharmacology
- Addiction Medicine
Background:
- Alprazolam dependence is a clinical concern.
- Managing alprazolam withdrawal requires careful consideration.
- Posttraumatic stress disorder (PTSD) frequently co-occurs with benzodiazepine use.
Purpose of the Study:
- To evaluate the safety and efficacy of clonazepam substitution for alprazolam discontinuation.
- To assess the incidence of withdrawal symptoms and seizures during alprazolam tapering.
- To investigate this method in patients with co-occurring PTSD.
Main Methods:
- An open-label study involving 37 alprazolam-dependent patients (17 inpatient, 20 outpatient).
- Gradual withdrawal from alprazolam using clonazepam substitution.
- Clinical observation for rebound panic and withdrawal syndromes.
Main Results:
- Two patients experienced rebound panic symptoms.
- No true withdrawal syndromes were observed in the study group.
- No instances of withdrawal seizures were reported.
Conclusions:
- Clonazepam substitution appears to be a safe and effective method for alprazolam discontinuation.
- This approach may mitigate the risk of severe withdrawal symptoms and seizures.
- Further controlled studies are warranted to confirm these findings.
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