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The dependence potential of short half-life benzodiazepines: a meta-analysis
1Health Policy Institute, Brandeis University, Waltham, MA 02254-9110.
Objectives:
The dependence potential of benzodiazepine medications is now widely recognized, but uncertainty exists as to whether use of short half-life vs long half-life drugs results in greater dependence. The present study reports a meta-analysis of the extant research to evaluate the dependence potential of different types of benzodiazepines.
Method:
Seven studies were found that specifically compared long half-life and short half-life benzodiazepines and allowed statistical comparison by their homogeneous dependent variables. Drugs in these studies were used as daytime sedatives.
Results:
Substantial evidence was found for differential effects of short vs long half-life drugs at withdrawal. In all studies, dropouts were higher among short half-life subjects. In the random-assignment short-term use studies, Hamilton Anxiety Scale scores showed higher incidence of rebound among subjects who used the short half-life drugs.
Conclusions:
The present meta-analysis confirms clinical impressions of the greater dependence potential of short vs long half-life benzodiazepines. Doctors, patients, and policymakers need to be informed so as to avoid harm to the public health through unintended drug dependence.