Benzodiazepine dependence of several years duration: clinical profile and therapeutic benefits

Twenty-two (22) patients with long-term benzodiazepine dependence ranging from 3.5 to 13 years (Mean 7.4 years) were referred to us for evaluation and treatment. Daily dosages ranged from 10 to 100 mg (Mean 43.8 mg) of diazepam or its equivalent. Psychiatric diagnosis by DSM-III criteria revealed that 13 (59.1%) had schizophrenic disorder; 7 (48%) had generalized anxiety disorder, and 2 (9.1%) had manic depression. Only one patient could be totally withdrawn and remain abstinent from benzodiazepines without substituting another psychotherapeutic drug. Benzodiazepine dependence appeared therapeutic in the majority of these patients since psychotic symptoms, anxiety, or alcohol abuse were reduced. Based on these observations and other studies, we suggest that long-term benzodiazepine dependence should not always be discontinued, since the patient may have severe underlying psychiatric and medical illnesses that are therapeutically well controlled.