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Long-term Therapeutic Use of Benzodiazepines:  II. Effects of Gradual Taper

Edward Schweizer, MD; Karl Rickels, MD; W. George Case, MD; David J. Greenblatt, MD
Arch Gen Psychiatry. 1990;47(10):908-915. doi:10.1001/archpsyc.1990.01810220024003.
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• We compared the effect on withdrawal severity and acute outcome of a 25% per week taper of short half-life vs long half-life benzodiazepines in 63 benzodiazepine-dependent patients. Patients unable to tolerate taper were permitted to slow the taper rate. Ninety percent of patients experienced a withdrawal reaction, but it was rarely more than mild to moderate. Nonetheless, 32% of long half-life and 42% of short half-life benzodiazepinetreated patients were unable to achieve a drug-free state. The most difficulty was experienced in the last half of taper. Baseline personality, high Eysenck neuroticism, female sex, and mild-tomoderate alcohol use were found to be more significant predictors of withdrawal severity than the daily benzodiazepine dose or benzodiazepine half-life. These findings suggest that personality factors contribute significantly to the patient's difficulties with gradual benzodiazepine discontinuation of therapeutic doses of benzodiazepines.


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