Voshaar, 2006 Strategies for discontinuing long-term benzodiazepine use: meta-analysis.

[Altostrata]

Br J Psychiatry. 2006 Sep;189:213-20. 

Strategies for discontinuing long-term benzodiazepine use: meta-analysis.

Voshaar RC¹, Couvée JE, van Balkom AJ, Mulder PG, Zitman FG.

 

Abstract and free full text at https://www.ncbi.nlm.nih.gov/pubmed/16946355

BACKGROUND:

The prevalence of benzodiazepine consumption in European countries remains at 2-3% of the general population despite the well-documented disadvantages of long-term use.

AIMS:

To review systematically the success rates of different benzodiazepine discontinuation strategies.

METHOD:

Meta-analysis of comparable intervention studies.

RESULTS:

Twenty-nine articles met inclusion criteria. Two groups of interventions were identified; minimal intervention (e.g. giving simple advice in the form of a letter or meeting to a large group of people; n=3), and systematic discontinuation (defined as treatment programmes led by a physician or psychologist; n=26). Both were found to be significantly more effective than treatment as usual: minimal interventions (pooled OR=2.8, 95% CI 1.6-5.1); systematic discontinuation alone (one study, OR=6.1, 95% CI 2.0-18.6). Augmentation of systematic discontinuation with imipramine (two studies, OR=3.1, 95% CI 1.1-9.4) or group cognitive-behavioural therapy for patients with insomnia (two studies, OR=5.5, 95% CI 2.3-14.2) was superior to systematic discontinuation alone.

CONCLUSIONS:

Evidence was found for the efficacy of stepped care (minimal intervention followed by systematic discontinuation alone) in discontinuing long-term benzodiazepine use.