Effectiveness of current treatment approaches for benzodiazepine discontinuation: A meta-analysis

Parr, Jannette M., Kavanagh, David J., Cahill, Lareina, Mitchell, Geoffrey and Young, Ross McD. (2009) Effectiveness of current treatment approaches for benzodiazepine discontinuation: A meta-analysis. Addiction, 104 1: 13-24. doi:10.1111/j.1360-0443.2008.02364.x

Author Parr, Jannette M.
Kavanagh, David J.
Cahill, Lareina
Mitchell, Geoffrey
Young, Ross McD.
Title Effectiveness of current treatment approaches for benzodiazepine discontinuation: A meta-analysis
Journal name Addiction   Check publisher's open access policy
ISSN 0965-2140
Publication date 2009-01
Year available 2008
Sub-type Article (original research)
DOI 10.1111/j.1360-0443.2008.02364.x
Volume 104
Issue 1
Start page 13
End page 24
Total pages 12
Editor Robert West
Place of publication United Kingdom
Publisher Wiley-Blackwell Publishing Ltd.
Collection year 2009
Language eng
Subject C1
Abstract Aims To assess the effectiveness of current treatment approaches to assist benzodiazepine discontinuation. Methods A systematic review of approaches to benzodiazepine discontinuation in general practice and out-patient settings was undertaken. Routine care was compared with three treatment approaches: brief interventions, gradual dose reduction (GDR) and psychological interventions. GDR was compared with GDR plus psychological interventions or substitutive pharmacotherapies. Results Inclusion criteria were met by 24 studies, and a further eight were identified by future search. GDR [odds ratio (OR) = 5.96, confidence interval (CI) = 2.08–17.11] and brief interventions (OR = 4.37, CI = 2.28–8.40) provided superior cessation rates at post-treatment to routine care. Psychological treatment plus GDR were superior to both routine care (OR = 3.38, CI = 1.86–6.12) and GDR alone (OR = 1.82, CI = 1.25–2.67). However, substitutive pharmacotherapies did not add to the impact of GDR (OR = 1.30, CI = 0.97–1.73), and abrupt substitution of benzodiazepines by other pharmacotherapy was less effective than GDR alone (OR = 0.30, CI = 0.14–0.64). Few studies on any technique had significantly greater benzodiazepine discontinuation than controls at follow-up. Conclusions Providing an intervention is more effective than routine care. Psychological interventions may improve discontinuation above GDR alone. While some substitutive pharmacotherapies may have promise, current evidence is insufficient to support their use.
Keyword Benzodiazepines
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
School of Medicine Publications
School of Psychology Publications
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Citation counts: TR Web of Science Citation Count  Cited 43 times in Thomson Reuters Web of Science Article | Citations
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Created: Fri, 12 Jun 2009, 12:49:47 EST by Siona Saplos on behalf of School of Medicine