Abstract
Introduction
Benzodiazepines are commonly prescribed for a variety of indications and can be employed in the short- and long-term. While they are efficacious, issues arise from long-term use with the emergence of dependence and tolerance to doses within the therapeutic range and beyond. Discontinuation from benzodiazepines can be problematic for patients and may result in a withdrawal syndrome, which can be protracted and last months to years.
Methods
26 participants received low-dose subcutaneous flumazenil infusions (4 mg/24 h for approximately eight days) as part of a randomised control crossover trial. Return to benzodiazepine use was assessed monthly for three months based on the benzodiazepine use in the previous week. Where data was not available, the treating psychiatrist examined patient files and clinical documents to determine benzodiazepine use. Withdrawal and craving scores were also measured.
Results
Abstinence rates from benzodiazepines at one-, two-, and three-month follow ups were 65.4%, 50%, and 46.2% respectively. When considering patient files and clinical documents, abstinence rates were higher at 73.1%, 65.4% and 61.5% at the one-, two-, and three-month follow ups respectively. Withdrawal and craving scores were higher in those that had returned to any benzodiazepine use.
Conclusion
Self-reported rates of abstinence from benzodiazepines at three months was between 46.2% and 61.5%. Flumazenil may yield greater success than benzodiazepine tapering from high dose (>30 mg diazepam equivalent) benzodiazepine use. Further research should compare abstinence rates after treatment with flumazenil compared to benzodiazepine tapering in high dose benzodiazepine users.
Benzodiazepines are commonly prescribed for a variety of indications and can be employed in the short- and long-term. While they are efficacious, issues arise from long-term use with the emergence of dependence and tolerance to doses within the therapeutic range and beyond. Discontinuation from benzodiazepines can be problematic for patients and may result in a withdrawal syndrome, which can be protracted and last months to years.
Methods
26 participants received low-dose subcutaneous flumazenil infusions (4 mg/24 h for approximately eight days) as part of a randomised control crossover trial. Return to benzodiazepine use was assessed monthly for three months based on the benzodiazepine use in the previous week. Where data was not available, the treating psychiatrist examined patient files and clinical documents to determine benzodiazepine use. Withdrawal and craving scores were also measured.
Results
Abstinence rates from benzodiazepines at one-, two-, and three-month follow ups were 65.4%, 50%, and 46.2% respectively. When considering patient files and clinical documents, abstinence rates were higher at 73.1%, 65.4% and 61.5% at the one-, two-, and three-month follow ups respectively. Withdrawal and craving scores were higher in those that had returned to any benzodiazepine use.
Conclusion
Self-reported rates of abstinence from benzodiazepines at three months was between 46.2% and 61.5%. Flumazenil may yield greater success than benzodiazepine tapering from high dose (>30 mg diazepam equivalent) benzodiazepine use. Further research should compare abstinence rates after treatment with flumazenil compared to benzodiazepine tapering in high dose benzodiazepine users.
Original language | English |
---|---|
Article number | 109517 |
Journal | Drug and Alcohol Dependence |
Volume | 237 |
DOIs | |
Publication status | Published - 1 Aug 2022 |