OBJECTIVE: The primary disadvantage of high-potency benzodiazepine
treatment for panic disorder is the difficulty of discontinuing the
treatment. During treatment discontinuation, new symptoms may emerge and
anxiety may return, preventing many patients from successfully
discontinuing their treatment. In this controlled, randomized trial the
authors investigated the efficacy of a cognitive-behavioral program for
patients with panic disorder who were attempting to discontinue treatment
with high-potency benzodiazepines. METHOD: Outpatients treated for panic
disorder with alprazolam or clonazepam for a minimum of 6 months and
expressing a desire to stop taking the medication (N = 33) were randomly
assigned to one of two taper conditions: a slow taper condition alone or a
slow taper condition in conjunction with 10 weeks of group
cognitive-behavioral therapy. RESULTS: The rate of successful
discontinuation of benzodiazepine treatment was significantly higher for
the patients receiving the cognitive-behavioral program (13 of 17; 76%)
than for the patients receiving the slow taper program alone (four of 16;
25%). There was no difference in the likelihood of discontinuation success
between the patients treated with alprazolam and those who received
clonazepam. At the 3-month follow-up evaluation, 77% of the patients in the
cognitive-behavioral program who successfully discontinued benzodiazepine
treatment remained benzodiazepine free. CONCLUSIONS: These findings support
the efficacy of cognitive-behavioral interventions in aiding benzodiazepine
discontinuation for patients with panic disorder.
Abstract Teaser