Personality and Symptom Sensitivity Predictors of Alprazolam Withdrawal in Panic Disorder
Abstract
BACKGROUND: Discontinuation of benzodiazepine (BZ) treatment results in a well-characterized withdrawal syndrome in 40-50% of anxious patients. While numerous studies have established the role of BZ dose, treatment duration, half-life, potency, rate of withdrawal and severity of underling anxiety disorder in predicting severity of withdrawal symptoms, fewer studies have examined the role of psychological and personality factors. METHOD: In 123 panic disorder patients undergoing gradual tapered discontinuation of alprazolam in conjunction with pre-treatment with carbamazepine or placebo, the relationship between measures of 'symptom sensitivity' and 'harm avoidance', and severity of withdrawal symptoms measured as peak severity of symptoms, time before taper needed to be slowed due to symptoms, and ability to complete taper, was examined. RESULTS: After controlling for the less substantial effects of dose, treatment duration, pre-taper anxiety and panic attack frequency, measures of symptom sensitivity and harm avoidance accounted for an additional 3-6% of withdrawal variance. CONCLUSIONS: These results show an effect of symptom sensitivity and harm avoidance on BZ withdrawal symptoms, comparable to prior findings linking dependent personality characteristics to withdrawal severity. Failure to show the expected effect on ability to complete taper may be due to either the more symptomatic nature of the patients in this study.
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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 [89]
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- Authors
- ROY-BYRNE, P., RUSSO, J., POLLACK, M., STEWART, R., BYSTRISKY, A., BELL, J., ROSENBAUM, J., CORRIGAN, M. H., STOLK, J., RUSH, A. J., & BALLENGER, J.
- Affiliations
- Harvard University (US)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2003-04
- Volume
- 33
- Issue
- 3
- Pages
- 511-518
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2044700137
- Cited by
- 11
- References
- 0
- Citations by year
- 2023: 1 · 2021: 1 · 2018: 1 · 2012: 1
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- benzodiazepine withdrawal syndrome, panic disorder, harm avoidance, personality traits, benzodiazepine tapering, carbamazepine, benzodiazepine dependence
- MeSH terms
- Adult, Alprazolam, Dose-Response Relationship, Drug, Female, Humans, Male, Patient Dropouts, Personality Disorders, Personality Inventory, Substance Withdrawal Syndrome, Anti-Anxiety Agents, Panic Disorder, Treatment Outcome
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