To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
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.
To review systematically the success rates of different benzodiazepine
Meta-analysis of comparable intervention studies.
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.
Evidence was found for the efficacy of stepped care (minimal intervention
followed by systematic discontinuation alone) in discontinuing long-term
Many patients with depression take benzodiazepine drugs long term despite the absence of continuing therapeutic value.
To evaluate a treatment programme involving gradual discontinuation with or without simultaneous selective serotonin reuptake inhibitor (SSRI) prescribing and to determine the long-term outcome after benzodiazepine withdrawal.
Patients went through three phases – change to an equivalent dose of diazepam; subsequent randomisation to either 20 mg of paroxetine or placebo; and gradual reduction of diazepam in depression-free patients – with a follow-up after 2 or 3 years.
A total of 230 patients were recruited and 75% in the paroxetine group and 61% in the placebo group were successfully treated after 6 weeks (P=0.067). After 2 or 3 years 13% of patients were still benzodiazepine free: 26% of those who had successfully tapered off benzodiazepine and 6% of the total group.
Transfer to diazepam followed by gradual withdrawal is an effective way of discontinuing chronic benzodiazepine use. The addition of SSRI treatment is of limited value.
Email your librarian or administrator to recommend adding this to your organisation's collection.