Long-term effectiveness of an intervention to discontinue chronic benzodiazepine use

Abstract

Introduction. We establish the long-term effectiveness of a brief intervention to withdraw from chronic benzodiazepine use.

Methods. Follow-up after a randomized clinical trial. Setting: Three health care centers covering 82,
inhabitants. Subjects: 135 patients who completed the previous clinical trial (66 from the intervention group, 63 from the control group, 6 had died). Intervention-measurements: The previous clinical trial compared an intervention consisting of standardized advice and a dose tapering schedule against a control group followed by usual care.

Results were evaluated at 12 months. Main outcome: benzodiazepine use three years after the end of the clinical trial, type of drug and the reason for prescription.
Results. After 3 years of follow up, 25/66 (37.9%) subjects from the intervention group and 14/63 (22.2%) from the control group were benzodiazepine free. The probability of withdrawal from benzodiazepine between patients in the intervention group was 41 % higher than in the control group. Relative risk: 1.41 (95% confidence interval: 0.98-1.66). In the intervention group, 16 from 31 (51.6%) patients who had withdrawn at 12 months were benzodiazepine free after 3 years. The most prescribed benzodiazepine is lorazepam (27.9%), followed by alprazolam (12.4%) and the main reason for prescription is anxiety (16.3%) followed by anxious-depressive disorder (10.9%).

Conclusions. Even though there is a substantial relapse rate, the intervention to reduce chronic benzodiazepine use remains effective in the long-term.