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Chronic benzodiazepine use in general practice patients with depression: an evaluation of controlled treatment and taper-off

机译:抑郁症一般患者中慢性苯二氮卓类药物的长期使用:对受控治疗和逐渐减量的评价

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Background Many patients with depression take benzodiazepine drugs long term despite the absence of continuing therapeutic value. Aims To evaluate a treatment programme involving gradual discontinuation with or without simultaneous selective serotonin reuptake inhibitor (SSRI) prescribing and to determine the long-term outcome after benzodiazepine withdrawal. Method Patients went through three phases a€” change to an equivalent dose of diazepam; subsequent randomisation to either 20 mg of paroxetine or placebo; and gradual reduction of diazepam in depression-free patients a€” with a follow-up after 2 or 3 years. Results A total of 230 patients were recruited and 75% in the paroxetine group and 61% in the placebo group were successfully treated after 6 weeks ( P =0.067). After 2 or 3 years 13% of patients were still benzodiazepine free: 26% of those who had successfully tapered off benzodiazepine and 6% of the total group. Conclusions Transfer to diazepam followed by gradual withdrawal is an effective way of discontinuing chronic benzodiazepine use. The addition of SSRI treatment is of limited value.
机译:背景许多抑郁症患者尽管缺乏持续治疗价值,但仍长期服用苯二氮卓类药物。目的评估包括或不同时使用选择性5-羟色胺再摄取抑制剂(SSRI)处方而逐步停用的治疗方案,并确定苯二氮卓类药物停用后的长期疗效。方法患者经历了三个阶段,即改变为相等剂量的地西epa;随后随机分配至20 mg帕罗西汀或安慰剂;并在2或3年后进行随访,从而使无抑郁症患者的地西epa逐渐减少。结果总共招募了230名患者,帕罗西汀组6周后成功治愈了75%(P = 0.067),安慰剂组为61%。 2年或3年后,仍有13%的患者不含苯二氮卓类药物:成功治愈苯二氮卓类药物的患者为26%,占全部患者的6%。结论转移至地西followed后逐渐停药是中止慢性苯二氮卓类药物长期使用的有效方法。 SSRI治疗的附加价值有限。

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