2010 Study -- Benzodiazepine tapering: A prospective study

Hi,

Here's a link to a 2010 study that followed people for a year after tapering from benzodiazepines:

 

http://www.ncbi.nlm.nih.gov/pubmed/20629611

 

I haven't found a link that allows for general viewing of the whole study, but I'll paste the "Conclusion" section here:

 

Conclusion

The purpose of the present investigation was to conduct

a follow-up of a group of long-term BZD users over a

1-year period following graded BZD withdrawal in terms

of various clinical symptoms and possible withdrawal

symptoms. More specifi cally, the aim of the present

study was to follow the development of clinical symptoms

prospectively over a 50-week time period, and to

determine whether it would be possible to differentiate

between clinical psychiatric symptoms and withdrawal

symptoms related to BZD tapering in this group of

chronic BZD users. The results showed that the frequency

and severity of clinical symptomatology, as measured

by the CPRS and the NADDI, signifi cantly decreased

over the course of the study. Results of a more detailed

analysis of possible patterns of symptoms on the CPRS

and on the NADDI revealed four patterns of symptoms.

The fi rst pattern consisted of symptoms that showed a

gradual decrease over the 50-week time period. This pattern

included an affective component, a cognitive component,

a motivational component illness component and

symptoms related to anxiety. The second pattern of

symptoms showed a signifi cant increase in the severity

of symptoms as a function of onset of tapering and a

signifi cant decrease in severity for the remainder of the

study. This pattern included an affective component, as

well as somatic, perceptual and autonomic disturbances.

The third pattern of symptoms was characterized by an

increase in the severity of symptoms 4 weeks after the

cessation of BZD tapering. The symptoms included in

this pattern were all related to affect. The fourth and

fi nal pattern included symptoms that seemed to be resistant

to change over the 50-week period. The fi nal pattern

included symptoms related to anxiety and reactive

depression, as well as perceptual disturbances. Rate of

BZD withdrawal was signifi cantly associated with CPRS

ratings of global illness taken at the time of admission

and measured at the end of treatment, but CPRS ratings of

global illness were not related to duration or dosage of

BZDs, type of BZD, prescriptive and/or non-prescriptive

drug use prior to admission, marital status, sex, or age.

The results of the present study provide a detailed picture

of the pattern of symptoms, their time course and

multidimensional determinants of the BZD withdrawal

symptoms.

 

Good find!  I don't have access to a CPRS survey, but I can imagine the stuff that is likely evaluated and am not surprised about the clusters.  Did you read the entire article?  Is it worth requesting a copy?

Hi,

Yes, I did read the whole study. It's written in the typical study fashion, with all of the detailed charts, lists, graphs, etc., but I was interested to understand the four patterns that are briefly mentioned in the abstract. I can't say whether it would be worthwhile for someone else to read. For me, it was good to see that someone was actually studying the withdrawal experience and reporting on it in a medical journal.

One statement from the conclusion that really caught my interest was that symptom improvement was not linked to the duration of benzo use.  That runs against what is often claimed in this forum.  Maybe I'll give it a read.  Thanks again for finding this.  I hope others will read the conclusions that you posted.

You're welcome! I think we need many more studies like this in order to understand benzo withdrawal. Those of us here all have stories, and I'm sure there are many, many more out there who don't fit into categories either. It's good to see some validation, though.

 

 

Hi Lapis,

 

Thank you for posting that study. How can I go about getting the full article? I want to copy this for my PCP. I'm so frustrated, I just want to go to my next appointment armed with as many studies as I can find that validate the protracted withdrawal syndrome, as well as the fact that a rapid withdrawal (which is what I endured in hospital) increases the likelihood of PWS....

Hi,

If you know anyone with access to a university library online, then they can hopefully find it for you. I found all the abstracts on PubMed, and then asked a friend to see if they could find the whole study. So, I have a bunch of Word documents now, but I can't post them here. I would if I could!

 

I agree that it's good to have validating information with you. I suggest you also print out the 2013 British National Formulary document that I posted elsewhere in this section. It gives an update on benzodiazepines, including information about "Dependence and Withdrawal", i.e. it can last 6-18 months after the last dose. Let me know if you're not able to find it, and I'll be happy to help.

Thank you. I will look up the BNF document as well.

 

Thank you for all the research you have posted, I am going to copy some of the Times Articles as well, just to show my doctor that acknowledgement is happening in other countries, unlike the US. 

It's my pleasure, Who-am-I! I was hoping that others would benefit from reading and sharing these studies and and newspaper articles. It's been helpful for me to have such documentation to share with medical professionals and family members, and I hope it's the same for others. Such information validates our experiences.

 

 

Hi,

If you know anyone with access to a university library online, then they can hopefully find it for you. I found all the abstracts on PubMed, and then asked a friend to see if they could find the whole study. So, I have a bunch of Word documents now, but I can't post them here. I would if I could!

 

I agree that it's good to have validating information with you. I suggest you also print out the 2013 British National Formulary document that I posted elsewhere in this section. It gives an update on benzodiazepines, including information about "Dependence and Withdrawal", i.e. it can last 6-18 months after the last dose. Let me know if you're not able to find it, and I'll be happy to help.

 

Hey, Lapis. When you're in Word, try copying by:  Edit: Select all >> Edit: Copy (or Ctrl+c) >> Right-click: paste.

 

I know this has been a problem and I inquired with folks on this site who are smarter than me, and they suggested this. Perhaps this will work. 

 

Great find. You find the best research.

One sin longatement from the conclusion that really caught my interest was that symptom improvement was not linked to the duration of benzo use.  That runs against what is often claimed in this forum.  Maybe I'll give it a read.  Thanks again for finding this.  I hope others will read the conclusions that you posted.

 

In the first line it says the purpose of the study was to investigate tapering and wd in long term users. Not sure how they define that or what it means.

Hey, Lapis. When you're in Word, try copying by:  Edit: Select all >> Edit: Copy (or Ctrl+c) >> Right-click: paste.

 

It's a copyright infringement to send the article out like that.