Benzodiazepines Tapering Interventions
Benzodiazepines and Addiction
It is common for clinicians to treat anxiety disorders and sleep disturbances with benzodiazepines (BZDs). In fact, BZDs are also used as adjuvant therapy for patients with schizophrenia, depression, and alcohol withdrawal problems.1 Effective medicines, short-term BZDs are wonderful treatment options; however, long-term use can lead to several unpleasant adverse effects. For one thing, benzodiazepines are well known for their extremely addictive properties; therefore, patients who take them regularly can easily develop a tolerance for them, becoming dependent upon them quickly.1 Unfortunately, long-term use can lead to somnolence, memory impairment, and daytime drowsiness.1 Drowsiness can lead to falls and hip fractures in the elderly and increase the chances for motor vehicle accidents in patients who drive.1 Despite the long list of drawbacks, clinicians continue to prescribe BZDs regularly. Many patients treated with benzodiazepines continue with treatment for months, years, and sometimes even decades.1
Withdrawal and Benzodiazepines
If possible, BZD prescriptions should be avoided; however, this is not always the case. When, and if, one is able to cease treatment with such medicines, gradual tapering is the most common withdrawal method.1 Benzodiazepines are difficult to stop use of, as their withdrawal symptoms cause severe discomfort in most people.1 Most commonly, nausea, vomiting, diarrhea, dizziness, and severe anxiety are all symptoms of withdrawal.1 Also, withdrawing too fast can cause seizures in some patients.1 Therefore, several studies have assessed the effectiveness of many withdrawal strategies for patients who are taking BZDs. As all the studies have differed in methodology, overall effectiveness, and cost-effectiveness, not one single form of withdrawal has been stated to be the best.1 One study focused on sending letters to long-term benzodiazepine patients with educational information about the adverse effects of long-term use, but it was a costly project and not many were moved enough to seek further treatment in order to discontinue its use.1 Overall, gradual discontinuation showed better results in patients decreasing their BZD usage, but trials differed in sample sizes and results.1 Adding psychological support to the gradual discontinuation had the most positive results, but it was also more costly.1
Tapering Off Benzodiazepines
It is important for future studies to focus more on pinpointing an effective withdrawal strategy that is low-cost and needs little professional time, as general practitioners are usually the doctors helping patients to taper off and their practices are limited in time and money.1 Research suggests that a combination of educational information and individual tapering programs will achieve discontinuation rates that are higher and consume less professional time.1 However, patients must be motivated for this strategy to be successful, which may be difficult with a medicine that is so addictive.1
 Vicens, C. et al. (2011). Comparative efficacy of two primary care interventions to assist withdrawal from long term benzodiazepine use: A protocol for a clustered, randomized clinical trial. BMC Family Practice. Retrieved from http://www.biomedcentral.com/1471-2296/12/23. benzodiazepines.