Hostname: page-component-745bb68f8f-b6zl4 Total loading time: 0 Render date: 2025-02-11T20:30:06.620Z Has data issue: false hasContentIssue false
  • English
  • Français

A Double-Blind Comparison of the Effects of Gradual Withdrawal of Lorazepam, Diazepam and Bromazepam in Benzodiazepine Dependence

Published online by Cambridge University Press:  03 January 2018

Siobhan M. Murphy  and
Peter Tyrer
Siobhan M. Murphy*
Affiliation:
St Thomas's Hospital, London SE1
Peter Tyrer
Affiliation:
St Charles' Hospital, London W10
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

Using a double-blind procedure, 68 patients with putative benzodiazepine dependence were randomly allocated to one of three groups given lorazepam (n = 22), diazepam (n = 23) or bromazepam (n = 23) in doses equivalent to those of the patients' original benzodiazepine. After four weeks the dosage was reduced in 25% quantities until no further benzodiazepines were taken. A total of 23 patients dropped out during the study, ten on lorazepam (one of whom committed suicide), seven on diazepam and six on bromazepam. There were few differences in withdrawal symptoms between the three groups but, despite the higher dropout rate, these symptoms were somewhat less marked in the lorazepam group. Withdrawal symptoms were greater in patients who had taken a benzodiazepine for > 5 years and were most marked in those with personality disorders, predominantly dependent ones.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 158 , Issue 4 , April 1991 , pp. 511 - 516
Copyright
Copyright © Royal College of Psychiatrists, 1991 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aranko, K. (1985) Development of tolerance and cross-tolerance to psychomotor effects of benzodiazepines in man. MD Thesis, University of Helsinki.Google Scholar
Asberg, M. Montgomery, S. A., Perris, C. et al (1978) A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica (Suppl. 271), 5–29.CrossRefGoogle Scholar
Ashton, H. (1984) Benzodiazepine withdrawal: an unfinished story. British Medical Journal, 288, 1135–1140.Google Scholar
Ashton, H. (1987) Benzodiazepine withdrawal: outcome in 50 patients. British Journal of Addiction, 82, 7–10.Google Scholar
Ashton, C. H., Rawlins, M. D. & Tyrer, S. P. (1990) A double-blind placebo controlled study of buspirone in diazepam withdrawal in chronic benzodiazepine abusers. British Journal of Psychiatry, 157, 232–238.Google Scholar
Ayd, F. J. Jr (1979) Benzodiazepine dependence and withdrawal. Journal of the American Medical Association. 242, 1401–1402.Google Scholar
British Medical Association And Royal Pharmaceutical Society (1989) British National Formulary, No. 18, pp. 146–148. London: Pharmaceutical Press.Google Scholar
Busto, U., Sellers, E. Naranjo, C. A. et al (1986) Withdrawal reaction after long-term therapeutic use of benzodiazepines. New England Journal of Medicine, 315, 854–859.Google Scholar
Cantopher, T., Olivieri, S., Cleave, N., et al (1990) Chronic benzodiazepine dependence: a comparative study of abrupt withdrawal under propranolol cover versus gradual withdrawal. British Journal of Psychiatry, 156, 406–411.Google Scholar
Clift, A. D. (1972) Factors leading to dependence on hypnotic drugs. British Medical Journal, 3, 614–617.Google Scholar
Griffiths, R. R., Lamb, R. J., Ator, N. A., et al (1985) Relative abuse liability of triazolam: experimental assessment in animals and humans. Neuroscience and Biobehavioral Reviews, 9, 133–151.Google Scholar
Hiogit, A., Lader, M. & Fonagy, P. (1985) Clinical management of benzodiazepine dependence. British Medical Journal, 291, 688–690.Google Scholar
Hopkins, D., Sethi, K. & Mucklow, J. (1982) Benzodiazepine withdrawal in general practice. Journal of the Royal College of General Practitioners, 32, 758–762.Google ScholarPubMed
Onyett, S. & Turpin, G. (1988) Benzodiazepine withdrawal in primary care: a comparison of behavioural group training and individual sessions. Behavioural Psychotherapy, 116, 297–312.Google Scholar
Pecknold, J. C., Swinson, R. P. Kuch, K. et al (1988) Agoraphobia in panic disorder and agoraphobia: results from a multi center trial. III. Discontinuation effects. Archives of General Psychiatry, 45, 429–436.Google Scholar
Petursson, H. & Lader, M. H. (1981) Withdrawal from long-term benzodiazepine treatment. British Medical Journal, 283, 643–645.Google Scholar
Priest, R. G. & Montgomery, S. A. (1988) Benzodiazepines and dependence: a College statement. Bulletin of the Royal College of Psychiatrists, 12, 107–109.Google Scholar
Rickels, K., Case, W. G., Downing, R. W. et al (1983) Long-term diazepam therapy and clinical outcome. Journal of the American Medical Association, 250, 767–771.Google Scholar
Rickels, K. Case, W. G., Schweizer, E. E., et al (1986) Low-dose dependence in chronic benzodiazepine users: a preliminary report on 119 patients. Psychopharmacology Bulletin, 22, 407–415.Google ScholarPubMed
Teare Skinner, P. (1982) Skills not pills: learning to cope with anxiety symptoms. Journal of the Royal College of General Practitioners, 34, 258–260.Google Scholar
Tyrer, P. (1978) Drug treatment of psychiatric patients in general practice. British Medical Journal, 2, 1008–1010.Google Scholar
Tyrer, P. (1988) Dependence as a limiting factor in the clinical use of minor tranquillizers. Pharmacology and Therapeutics, 36, 173–188.Google Scholar
Tyrer, P. (1989) Tranquillisers in clinical practice. Update, 195–291.Google Scholar
Tyrer, P. & Alexander, J. (1979) Classification of personality disorder. British Journal of Psychiatry, 135, 163–167.CrossRefGoogle ScholarPubMed
Tyrer, P. & Murphy, S. (1987) The place of benzodiazepines in psychiatric practice. British Journal of Psychiatry, 151, 719–723.Google Scholar
Tyrer, P., Rutherford, D. & Hugoett, T. (1981) Benzodiazepine withdrawal symptoms and propranolol. Lancet, i, 520–522.Google Scholar
Tyrer, P., Casey, P. & Gall, J. (1983) The relationship between neurosis and personality disorder. British Journal of Psychiatry, 142, 404–408.CrossRefGoogle ScholarPubMed
Tyrer, P., Owen, R. & Dawling, S. (1983) Gradual withdrawal of diazepam after long-term therapy. Lancet, i, 1402–1406.Google Scholar
Tyrer, P., Owen, R. & Cicchetti, D. (1984) The Brief Scale for Anxiety: a subdivision of the Comprehensive Psychopathological Rating Scale. Journal of Neurology, Neurosurgery and Psychiatry, 47, 970–975.Google Scholar
Tyrer, P., Seivewright, N., Murphy, S., et al (1988) The Nottingham study of neurotic disorder: comparison of drug and psychological treatments. Lancet, ii, 235–240.Google Scholar
Tyrer, P., Murphy, S. & Riley, P. (1990) The Benzodiazepine Withdrawal Symptom Questionnaire. Journal of Affective Disorders, 19, 53–61.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.