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Benzodiazepine and z-drug withdrawal - Management
Basis for recommendation
These recommendations are in line with published reviews and guidelines on managing benzodiazepine dependence and are based on expert opinion and limited evidence [Lader and Russell, 1993; Mant and Walsh, 1997; Ashton, 2002b; Australian Government Department of Health and Ageing, 2004; Taylor et al, 2007].
Adjunct drug therapy
- Use of adjunct drug therapy to assist benzodiazepine withdrawal is not routinely recommended because there is no good evidence to support its use.
- Although propranolol is recommended by the British National Formulary for managing withdrawal symptoms when other measures have failed [BNF 56, 2008], the evidence for its effectiveness is poor.
Adjunct psychological intervention
- There is limited evidence to support the use of adjunct psychotherapy to promote benzodiazepine withdrawal.
- It is recognized that the choice of, and response to, these treatments will depend very much on the individual and may be helpful for those having difficulty while withdrawing [Ashton, 2002d; Lingford-Hughes et al, 2004].
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