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Withdrawal from long-term benzodiazepine treatment
British Medical Journal (Clinical Research Ed.)
|September 5, 1981
Summary
Long-term benzodiazepine use can lead to dependence. Gradual withdrawal caused significant reactions in patients, highlighting risks associated with these medications for chronic anxiety.
Area of Science:
- Pharmacology
- Neuroscience
- Clinical Psychology
Background:
- Benzodiazepines are commonly prescribed for anxiety disorders.
- Long-term use may lead to physical dependence.
- Discontinuation symptoms are a concern for patients on these medications.
Purpose of the Study:
- To investigate the withdrawal reactions in patients discontinuing long-term, normal-dose benzodiazepine treatment.
- To assess the clinical and electrophysiological changes during benzodiazepine withdrawal.
Main Methods:
- A gradual, placebo-controlled, double-blind discontinuation protocol was used.
- 16 patients suspected of benzodiazepine dependence were included.
- Withdrawal symptoms, sleep, appetite, weight, electroencephalography (EEG), and psychological performance (Digit Symbol Substitution Test) were monitored.
Main Results:
- All patients experienced withdrawal reactions, including anxiety, dysphoria, and perceptual changes.
- Symptoms peaked during discontinuation but typically resolved within 2-4 weeks.
- EEG showed reduced fast-wave activity, and psychological performance improved post-withdrawal.
- Sleep disturbances, appetite changes, and weight loss were also observed.
Conclusions:
- Long-term, normal-dose benzodiazepine treatment carries a risk of dependence.
- Gradual withdrawal can precipitate significant, though often transient, adverse reactions.
- Benzodiazepines may not be suitable for regular daily treatment of chronic anxiety due to dependence risks.