Effectiveness of current treatment approaches for benzodiazepine discontinuation : a meta-analysis.

Parr, Jannette M., Kavanagh, David J., Cahill, Lareina, Mitchell, Geoffrey K., & Young, Ross McD. (2009) Effectiveness of current treatment approaches for benzodiazepine discontinuation : a meta-analysis. Addiction, 104(1), pp. 13-24.

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Aims: To assess the effectiveness of current treatment approaches to assist benzodiazepine discontinuation.

Methods: A systematic review of approaches to benzodiazepine discontinuation in general practice and out-patient settings was undertaken. Routine care was compared with three treatment approaches: brief interventions, gradual dose reduction (GDR) and psychological interventions. GDR was compared with GDR plus psychological interventions or substitutive pharmacotherapies.

Results: Inclusion criteria were met by 24 studies, and a further eight were identified by future search. GDR [odds ratio (OR) = 5.96, confidence interval (CI) = 2.08–17.11] and brief interventions (OR = 4.37, CI = 2.28–8.40) provided superior cessation rates at post-treatment to routine care. Psychological treatment plus GDR were superior to both routine care (OR = 3.38, CI = 1.86–6.12) and GDR alone (OR = 1.82, CI = 1.25–2.67). However, substitutive pharmacotherapies did not add to the impact of GDR (OR = 1.30, CI = 0.97– 1.73), and abrupt substitution of benzodiazepines by other pharmacotherapy was less effective than GDR alone (OR = 0.30, CI = 0.14–0.64). Few studies on any technique had significantly greater benzodiazepine discontinuation than controls at follow-up.

Conclusions: Providing an intervention is more effective than routine care. Psychological interventions may improve discontinuation above GDR alone. While some substitutive pharmacotherapies may have promise, current evidence is insufficient to support their use.

Impact and interest:

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ID Code: 29155
Item Type: Journal Article
Refereed: Yes
Keywords: Treatment effectiveness, Benzodiazepine discontinuation, Intervention, Outpatients
DOI: 10.1111/j.1360-0443.2008.02364.x
ISSN: 0965-2140
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Psychology & Counselling
Deposited On: 08 Dec 2009 03:45
Last Modified: 29 Feb 2012 14:07

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