| Title | The long-term outcome of a benzodiazepine discontinuation programme in depressed outpatients. | | Author(s) | Couvée JE, Timmermans MA, Zitman FG, Dutch Chronic Benzodiazepine Working Group | | Institution | Medical Department, SmithKline Beecham Farma B.V., P.O. Box 3120, 2280 GC, Rijswijk, The Netherlands. jaap.e.couvee@sb.com | | Source | J Affect Disord 2002 Jul; 70(2):133-41. | | MeSH | Adult
Benzodiazepines
Chronic Disease
Cross-Sectional Studies
Depressive Disorder, Major
Drug Administration Schedule
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prescriptions, Drug
Psychotropic Drugs
Research Support, Non-U.S. Gov't
Treatment Outcome
| | Abstract | OBJECTIVE: To assess longitudinally the prescription of psychotropic drugs in depressed patients after they participated in a benzodiazepine discontinuation programme.
METHODS: Two hundred and thirty depressed patients on chronic benzodiazepine therapy took part in a discontinuation programme conducted in 36 general practices. After 2.3 years (S.D.=0.65, range 0.1-3.6) medical records were reviewed.
RESULTS: Follow-up was achieved for 207 (90%) patients. Twenty-five (12%) patients remained benzodiazepine free during the full follow-up period. The majority (n=181, 87%) was prescribed benzodiazepines at an average of 13 (+/-14) mg of diazepam equivalents for 537 (+/-375) days. Fifty-five (74% of 74) of the successfully discontinued patients restarted benzodiazepine therapy. Sixty-eight (33%) patients were prescribed benzodiazepines during the whole follow-up period. Successful taper predicted no or lower subsequent benzodiazepine prescription rates (OR=7.3; 95% CI: 2-16). No influence of GP policy towards benzodiazepine prescription could be detected (P=0.275). Antidepressants were prescribed in 115 (55%) patients for an average duration of 476 (+/-360) days. There was no difference in benzodiazepine prescription (dosage, duration) between patients who had or had not been prescribed an antidepressant. LIMITATIONS: Patients were not been diagnosed systematically during the follow-up period.
CONCLUSIONS: If measured longitudinally, the rate of benzodiazepine prescription after discontinuation is much higher than reported in previous studies that have measured this cross-sectionally. Successful discontinuation is a strong predictor of modest or no future benzodiazepine prescription. Two-thirds of patients altered their benzodiazepine usage after taking part in a discontinuation programme. Treatment with antidepressants does not seem to influence benzodiazepine prescription. Patients' request (not GPs'policy) seems to be an important factor in continuing or resuming benzodiazepine prescription. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 12117625 |
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