The Long-Term Outcome of a Benzodiazepine Discontinuation Programme in Depressed Outpatients
Abstract
Objective To assess longitudinally the prescription of psychotropic drugs in depressed patients after they participated in a benzodiazepine discontinuation programme.Methods Two hundred and thirty depressed patients on chronic benzodiazepine therapy took part in a discontinuation programme conducted in 36 general practices. After 2.3 years (S.D.=0.65, range 0.1-3.6) medical records were reviewed.Results Follow-up was achieved for 207 (90%) patients. Twenty-five (12%) patients remained benzodiazepine free during the full follow-up period. The majority (n=181, 87%) was prescribed benzodiazepines at an average of 13 (+/-14) mg of diazepam equivalents for 537 (+/-375) days. Fifty-five (74% of 74) of the successfully discontinued patients restarted benzodiazepine therapy. Sixty-eight (33%) patients were prescribed benzodiazepines during the whole follow-up period. Successful taper predicted no or lower subsequent benzodiazepine prescription rates (OR=7.3; 95% CI: 2-16). No influence of GP policy towards benzodiazepine prescription could be detected (P=0.275). Antidepressants were prescribed in 115 (55%) patients for an average duration of 476 (+/-360) days. There was no difference in benzodiazepine prescription (dosage, duration) between patients who had or had not been prescribed an antidepressant.Limitations Patients were not been diagnosed systematically during the follow-up period.Conclusions If measured longitudinally, the rate of benzodiazepine prescription after discontinuation is much higher than reported in previous studies that have measured this cross-sectionally. Successful discontinuation is a strong predictor of modest or no future benzodiazepine prescription. Two-thirds of patients altered their benzodiazepine usage after taking part in a discontinuation programme. Treatment with antidepressants does not seem to influence benzodiazepine prescription. Patients' request (not GPs'policy) seems to be an important factor in continuing or resuming benzodiazepine prescription.
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Psychopathological variables, such as psychological suffering, anxiety or insomnia, best predict relapse rates in benzodiazepine withdrawal programs.
“but it is the psychopathological variables [86,87,88,89,90,91] (e.g., psychological suffering, anxiety or insomnia) which best predict relapse rates in withdrawal programs.”
From Cognitive behavioral therapy and acceptance and commitment therapy for the discontinuation of long-term benzodiazepine use in insomnia and anxiety disorders (2021) · cites this paper as [88]
Insomnia is a notable symptom of withdrawal syndromes and a factor of relapse.
“Insomnia is a notable symptom of withdrawal syndromes and a factor of relapse as emphasized by many studies [38,88,90].”
From Cognitive behavioral therapy and acceptance and commitment therapy for the discontinuation of long-term benzodiazepine use in insomnia and anxiety disorders (2021) · cites this paper as [88]
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References 9 · Cited by 20
- Authors
- Couvée, J. E., Timmermans, M. A. Y., & Zitman, F. G.
- Corresponding author
- Couvée, Jaap E.
- ORCID
- Zitman, Frans G.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2002-07
- Volume
- 70
- Issue
- 2
- Pages
- 133-141
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2065430497
- Cited by
- 20
- References
- 9
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 1 · 2017: 1 · 2014: 2
- FWCI
- 1.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- benzodiazepine discontinuation, depression, benzodiazepine prescriptions, antidepressants, tapering, general practice, long-term outcomes, benzodiazepine dependence
- MeSH terms
- Adult, Benzodiazepines, Chronic Disease, Cross-Sectional Studies, Major Depressive Disorder, Depressive Disorder, Major, Drug Administration Schedule, Female, Follow-Up Studies, Humans, Male, Middle Aged, Drug Prescriptions, Psychotropic Drugs, Treatment Outcome
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