The diagnosis and management of benzodiazepine dependence

Current Opinion in Psychiatry
Heather Ashton

Abstract

Despite repeated recommendations to limit benzodiazepines to short-term use (2-4 weeks), doctors worldwide are still prescribing them for months or years. This over-prescribing has resulted in large populations of long-term users who have become dependent on benzodiazepines and has also led to leakage of benzodiazepines into the illicit drug market. This review outlines the risks of long-term benzodiazepine use, gives guidelines on the management of benzodiazepine withdrawal and suggests ways in which dependence can be prevented. Recent literature shows that benzodiazepines have all the characteristics of drugs of dependence and that they are inappropriately prescribed for many patients, including those with physical and psychiatric problems, elderly residents of care homes and those with comorbid alcohol and substance abuse. Many trials have investigated methods of benzodiazepine withdrawal, of which the keystones are gradual dosage tapering and psychological support when necessary. Several studies have shown that mental and physical health and cognitive performance improve after withdrawal, especially in elderly patients taking benzodiazepine hypnotics, who comprise a large proportion of the dependent population. Benzodiazepi...Continue Reading

References

Jan 19, 1991·Lancet·I SavicS Stone-Elander
May 12, 1990·BMJ : British Medical Journal·A Holton, P Tyrer
Aug 1, 1990·The British Journal of Psychiatry : the Journal of Mental Science·C H AshtonS P Tyrer
Feb 1, 1987·Journal of Clinical Psychopharmacology·M Lader, D Olajide
Jun 1, 1987·Journal of Clinical Psychopharmacology·D Olajide, M Lader
Jun 1, 1987·British Journal of Addiction·H Ashton
Apr 1, 1989·The American Journal of Psychiatry·R K RiesS Cullison
Mar 7, 1981·Lancet·P TyrerT Huggett
Jan 1, 1981·International Pharmacopsychiatry·C Hallstrom, M Lader
Apr 1, 1983·Drugs·R T Owen, P Tyrer
Jun 25, 1983·Lancet·P TyrerS Dawling
Jan 1, 1981·British Journal of Addiction·H Petursson, M H Lader
Nov 1, 1994·Addiction·H Ashton
Dec 1, 1993·Journal of Clinical Psychopharmacology·L E HollisterR I Shader
Mar 1, 1993·Drug and Alcohol Dependence·N Seivewright, W Dougal
Apr 1, 1996·The British Journal of Psychiatry : the Journal of Mental Science·P TyrerP Barczak
Apr 26, 2001·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·D CrockfordB Campbell
Jan 29, 2002·Current Pharmaceutical Design·A N Bateson
May 3, 2003·Pharmacology & Therapeutics·C Allison, J A Pratt
Sep 11, 2003·Drugs & Aging·Martien J M PannemanRon M C Herings
Oct 15, 2003·Psychiatric Services : a Journal of the American Psychiatric Association·Mary F BrunetteRobert E Drake
Nov 25, 2003·Alcohol and Alcoholism : International Journal of the Medical Council on Alcoholism·Björn Axel JohanssonIngrid Persson
Dec 23, 2003·Journal of the American Geriatrics Society·Shelly L GrayAndrea Z LaCroix
Jan 2, 2004·The American Journal of Psychiatry·Ripu D JindalMichael E Thase
Jan 2, 2004·Scottish Medical Journal·G Stenhouse, J H Grieve
Jan 21, 2004·CNS Drugs·Melinda J BarkerSimon F Crowe
Feb 10, 2004·CNS Spectrums·Mark H PollackUNKNOWN World Council of Anxiety
Feb 10, 2004·CNS Spectrums·Michael Van AmeringenUNKNOWN World Council of Anxiety
Feb 10, 2004·CNS Spectrums·Christer AllgulanderUNKNOWN World Council of Anxiety
Mar 9, 2004·The Journal of Clinical Psychiatry·Robin E ClarkMary F Brunette
Mar 9, 2004·Journal of Psychiatric Research·Dalva PoyaresSergio Tufik
Mar 11, 2004·Journal of Neurochemistry·Laura HuopaniemiUwe Rudolph
Mar 23, 2004·Archives of Clinical Neuropsychology : the Official Journal of the National Academy of Neuropsychologists·Melinda J BarkerSimon F Crowe
Apr 2, 2004·The American Journal of Psychiatry·Marcia ValensteinFrederic C Blow
Apr 20, 2004·Accident; Analysis and Prevention·K L L MovigA C G Egberts
Jun 23, 2004·British Journal of Clinical Pharmacology·Geoffrey K IsbisterIan M Whyte
Jul 28, 2004·Traffic Injury Prevention·J Michael WalshTimothy J Kerns
Jul 28, 2004·Archives of Internal Medicine·Anita K WagnerDennis Ross-Degnan
Sep 1, 2004·Expert Opinion on Drug Safety·Subramoniam Madhusoodanan, Olivera J Bogunovic

❮ Previous
Next ❯

Citations

Feb 8, 2011·European Journal of Clinical Pharmacology·Maria RikalaSirpa Hartikainen
Mar 12, 2008·Wiener medizinische Wochenschrift·Wolfgang HarthUwe Gieler
Dec 21, 2007·Pharmacy World & Science : PWS·Geeske Brecht Ten WoldeF G Zitman
Feb 21, 2013·International Journal of Clinical Pharmacy·Suela KelliciGenc Burazeri
Apr 28, 2010·Canadian Journal on Aging = La Revue Canadienne Du Vieillissement·Philippe VoyerSarah-Gabrielle Béland
Feb 8, 2013·Canadian Journal on Aging = La Revue Canadienne Du Vieillissement·Pamphile-Gervais Nkogho MenguePhilippe Voyer
Sep 15, 2010·International Psychogeriatrics·Maria RikalaSirpa Hartikainen
Jun 20, 2008·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Anne E HeikkinenEsa R Korpi
Aug 8, 2009·Journal of Community Health Nursing·Philippe VoyerSarah-Gabrielle Beland
Apr 7, 2007·European Journal of Public Health·Thijs FassaertC Joris Yzermans
May 17, 2011·BMC Family Practice·Sophia RosmanNathalie Pelletier-Fleury
Jun 27, 2007·The Tohoku Journal of Experimental Medicine·Kyoko NomuraEiji Yano
Jul 14, 2012·Risk Management and Healthcare Policy·Marco FacciniFabio Lugoboni
Mar 24, 2010·Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists·Stephen Jurd
Sep 7, 2013·The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists·Jeannette Y Wick
Oct 16, 2014·Indian Journal of Psychiatry·Prasanthi NattalaLinda B Cottler
Jan 25, 2011·Social Psychiatry and Psychiatric Epidemiology·Caroline M SonnenbergAartjan T F Beekman
May 21, 2011·BMC Psychiatry·Kevin W ChenDevang Gandhi
Jul 16, 2010·Nordic Journal of Psychiatry·Britt VikanderArto J Hiltunen
Jan 29, 2016·Epidemiology and Psychiatric Sciences·G Guaiana, C Barbui
Jan 7, 2016·Current Psychiatry Reports·Malcolm Lader, Andri Kyriacou
Nov 21, 2012·Adolescent Medicine: State of the Art Reviews·Theresa Rohr-Kirchgraber, Zeina Melhem Nabhan
Jan 16, 2013·The Journal of Thoracic and Cardiovascular Surgery·Benjamin G ArensonRakesh C Arora
Nov 30, 2011·Progress in Neuro-psychopharmacology & Biological Psychiatry·Rei KitajimaNoboru Yamaguchi
Nov 1, 2011·General Hospital Psychiatry·Shao-Chien ChenMing-Been Lee
Jun 2, 2009·Addictive Behaviors·Jannette M ParrJason P Connor
Dec 28, 2012·Critical Care Medicine·Juliana BarrUNKNOWN American College of Critical Care Medicine
Apr 8, 2015·Journal of Gerontological Nursing·Kalin M CliffordJennifer Shaw
Sep 1, 2015·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Jonathon R Howlett, Murray B Stein
Feb 19, 2008·Progress in Neuro-psychopharmacology & Biological Psychiatry·J De RossM J Nobre
Jul 22, 2015·General Hospital Psychiatry·Michelle RichardsonLen Bowers
Mar 19, 2008·Human Psychopharmacology·Panagiotis OulisGeorge N Papadimitriou
Dec 18, 2007·Journal of the European Academy of Dermatology and Venereology : JEADV·W HarthU Gieler
Feb 22, 2011·Journal of Clinical Pharmacy and Therapeutics·J FisherI Sketris

❮ Previous
Next ❯

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