Withdrawing Benzodiazepines in Patients With Anxiety Disorders
Abstract
The large class of CNS-depressant medications-the benzodiazepines-have been extensively used for over 50 years, anxiety disorders being one of the main indications. A substantial proportion (perhaps up to 20-30 %) of long-term users becomes physically dependent on them. Problems with their use became manifest, and dependence, withdrawal difficulties and abuse were documented by the 1980s. Many such users experience physical and psychological withdrawal symptoms on attempted cessation and may develop clinically troublesome syndromes even during slow tapering. Few studies have been conducted to establish the optimal withdrawal schedules. The usual management comprises slow withdrawal over weeks or months together with psychotherapy of various modalities. Pharmacological aids include antidepressants such as the SSRIs especially if depressive symptoms supervene. Other pharmacological agents such as the benzodiazepine antagonist, flumazenil, and the hormonal agent, melatonin, remain largely experimental. The purpose of this review is to analyse the evidence for the efficacy of the usual withdrawal regimes and the newer agents. It is concluded that little evidence exists outside the usual principles of drug withdrawal but there are some promising leads.
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Abrupt discontinuation of zolpidem is associated with rebound insomnia.
“(2) two reports of abrupt discontinuation of zolpidem were associated with rebound insomnia [32, 33]”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [32]
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- Authors
- Lader, M., & Kyriacou, A.
- Affiliations
- King's College London (GB)
- Corresponding author
- Lader, Malcolm
- Venue
- Current Psychiatry Reports
- Published
- 2016-01
- Volume
- 18
- Issue
- 1
- Pages
- 8-8
- ISSN
- 1523-3812 (ISSN-L)
- 1535-1645
- OpenAlex
- W2227785996
- Semantic Scholar
- b2f962eae8bc58908b4e4ff8a9addaf1b54301c5
- Cited by
- 67
- References
- 80
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 5 · 2023: 6 · 2022: 7 · 2021: 11 · 2020: 15 · 2019: 5 · 2018: 6 · 2017: 4
- FWCI
- 0.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Psychiatry Reports (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- benzodiazepine withdrawal, benzodiazepine dependence, anxiety disorders, benzodiazepine tapering, withdrawal symptoms, flumazenil, melatonin, selective serotonin reuptake inhibitors, antidepressants, psychotherapy, central nervous system depressants
- MeSH terms
- Long Term Adverse Effects, Anxiety Disorders, Benzodiazepines, Humans, Psychotherapy, Substance Withdrawal Syndrome, Substance-Related Disorders, Withholding Treatment
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