[Benzodiazepine withdrawal with carbamazepine]

Seventeen patients who had been dependent on benzodiazepines for more than 0.5 years were subjected to abrupt withdrawal with carbamazepine (CBZ, 400 mg twice a day). Most patients were had been taking benzodiazepines because of panic disorder or neurosis. In 2 cases the patients were regarded as having high dose dependency. In 2 others withdrawal was discontinued because of loss of motivation or medical problems (HIV infection). During the withdrawal the patients were rated daily for anxiety, mood alterations, perception disturbances, neurological symptoms, and vegetative signs. Perception disturbances were noted in 14 patients. Most patients showed sleep disturbances, mood alterations or anxiety. Epileptic seizures, a well known complication of benzodiazepine withdrawal, did not occur. The CBZ treatment was well tolerated by all patients and caused no severe problems. Compared with a gradual tapering off of benzodiazepines, abrupt withdrawal plus CBZ medication seems to be better tolerated; in particular, the period of hospitalization for these patients can be shorter. Because anxiety, the reason for the benzodiazepine treatment in many cases, often recurs, the patients must be offered continuous after-care to prevent a new dependence.