2001/04/01 by Frans G. Zitman, Jaap E. Couvée · 6 citations
Medicine · Psychology · #Anesthesia #Antidepressant #Anxiety #Benzodiazepine #Depression (economics) #Diazepam #Discontinuation #Internal medicine #Medicine #Mental Health Treatment and Access #Paroxetine #Placebo #Psychiatry #Sleep and related disorders #Treatment of Major Depression
paper · pdf · doi:10.1192/bjp.178.4.317
openalex publication_date 2001/04/01 · openalex created_date 2016/06/24 · openalex updated_date 2026/08/03
BACKGROUND: Many patients with depression take benzodiazepine drugs long term despite the absence of continuing therapeutic value. AIMS: To evaluate a treatment programme involving gradual discontinuation with or without simultaneous selective serotonin reuptake inhibitor (SSRI) prescribing and to determine the long-term outcome after benzodiazepine withdrawal. METHOD: Patients went through three phases - change to an equivalent dose of diazepam; subsequent randomisation to either 20 mg of paroxetine or placebo; and gradual reduction of diazepam in depression-free patients - with a follow-up after 2 or 3 years. RESULTS: A total of 230 patients were recruited and 75% in the paroxetine group and 61% in the placebo group were successfully treated after 6 weeks (P:=0.067). After 2 or 3 years 13% of patients were still benzodiazepine free: 26% of those who had successfully tapered off benzodiazepine and 6% of the total group. CONCLUSIONS: Transfer to diazepam followed by gradual withdrawal is an effective way of discontinuing chronic benzodiazepine use. The addition of SSRI treatment is of limited value.