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Strategies for Treating Benzodiazepine Dependence
Benzodiazepine dependence occurs in about half of the patients who take the drugs longer than 1 month, according to a recent review article in The New England Journal of Medicine. Although more are needed, evidence-based strategies to treat patients dependent on benzodiazepines are available, and the prognosis using standard treatment is usually good.
Generally, a high level of evidence exists for the gradual withdrawal of benzodiazepines over a period of several weeks or months to prevent seizures and avoid severe withdrawal symptoms, reports author Michael Soyka, MD, Ludwig Maximilian University, Munich, and Medical Park Chiemseeblick, Bernau, Germany.
Psychotherapeutic interventions in patients with benzodiazepine dependence have 3 goals: to facilitate withdrawal, facilitate further abstinence, and treat the underlying disorder, according to the article.
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“In psychotherapy, good evidence exists for cognitive behavioral therapy and motivational approaches,” writes Dr. Soyka, also of Privatklinik Meiringen in Meiringen, Switzerland, “and for providing information and psychoeducation.”
However, attempting benzodiazepine withdrawal may not be appropriate in every case of dependence, the article points out.
“If patients have severe psychopathological symptoms, one can refrain from attempting withdrawal, given that the process often lasts for weeks and is sometimes distressing for the patient and the physician,” Dr. Soyka writes. “Also, withdrawal can be difficult to achieve in some elderly persons with long-term, low-dose dependence on hypnotic agents.”
In such cases, simply working to reduce the dose can decrease harm.
—Jolynn Tumolo
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