Short- and long-term results of a systematic benzodiazepine discontinuation programme for psychiatric patients
background Although guidelines for the use of benzodiazepines emphasise that these drugs should only be prescribed for short periods of time, in practice long-term usage persists and can be a serious problem. There is a fear among patients and among doctors prescribing the drugs that symptoms will become more acute if attempts are made to terminate the regimen.
aim To determine the short- and long-term results of a standardized method for discontinuing the use of benzodiazepines (bzd) and to test whether these results were related to the age and gender of the patients, the bzd dosage level and the treatment modality.
method A retrospective cohort study was performed at the Department of Psychiatry of the Radboud University Nijmegen Medical Centre. A systematic bzd discontinuation programme was offered by the Department of Psychiatry to patients who had been using bzd for at least three months. By studying the medical records, by conducting telephone interviews and by examining the prescription data of the GP or the pharmacy it was ascertained how many patients managed to become abstinent in the short- and long-term.
results Upon termination of the discontinuation programme 65% of the patients had managed to stop taking bzd and at follow-up approximately 2 years later 37% of the patients interviewed had not used bzd for the last 3 months. Neither age, nor gender, nor treatment modality predicted bzd usage immediately after the end of the discontinuation programme or at the 2-year follow-up. A high dose of bzd was the only significant predictor of post-programme usage 2 years later.
conclusion A systematic discontinuation programme seems to be just as effective for psychiatric patients as it is for general practice patients and deserves to be included in the regular treatment programmes provided by psychiatric practices.