Pharmacological interventions for benzodiazepine discontinuation in chronic benzodiazepine users.

What this study found

No pharmacological add-on can be recommended to facilitate benzodiazepine discontinuation. The evidence was very low to low quality, based on a small number of mostly small trials, and adverse events were poorly reported. Some agents showed limited signals in single or pooled trials, such as valproate for end-of-treatment discontinuation (RR 2.55, 95% CI 1.08 to 6.03) and flumazenil for withdrawal symptoms (SMD -0.95, 95% CI -1.71 to -0.19), but most pooled discontinuation effects were not significant, including carbamazepine (RR 1.33, 95% CI 0.99 to 1.80), lithium (RR 1.05, 95% CI 0.86 to…

Study & population

Systematic review of randomized trials in adults with chronic benzodiazepine use or benzodiazepine dependence, mostly outpatient populations with psychiatric or somatic comorbidity.

Intervention

Multiple adjunct pharmacologic agents were evaluated as aids to benzodiazepine tapering or discontinuation in chronic users, including valproate, carbamazepine, lithium, pregabalin, paroxetine, tricyclic antidepressants, alpidem, buspirone, melatonin, flumazenil, propranolol, progesterone, magnesium aspartate,…

Key limitation

Evidence quality was very low to low, with few trials and small sample sizes for most interventions.

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