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Am J Psychiatry 1991; 148:517-523
Copyright © 1991 by American Psychiatric Association
Controlled discontinuation of benzodiazepine treatment for patients with panic disorder
R Noyes Jr, MJ Garvey, B Cook and M Suelzer
Department of Psychiatry, University of Iowa College of Medicine, Iowa City.
OBJECTIVE: The purpose of this study was to compare the effects of
discontinuing treatment with intermediate- and long-acting benzodiazepines.
METHOD: Fifty patients with panic disorder who had taken part in a
double-blind treatment study and had responded to alprazolam, diazepam, or
placebo for 8 months were asked to stop taking these medications gradually.
RESULTS: After a relatively rapid dose reduction, the majority of patients
relapsed. Rebound anxiety and withdrawal symptoms were identified in a
substantial minority of patients. Those who were taking alprazolam showed
earlier and more intense rebound anxiety and withdrawal symptoms than did
the patients who received diazepam. Both the level of pretreatment anxiety
and the drug the patient was taking predicted the level of anxiety when
drug treatment was discontinued. CONCLUSIONS: The findings indicate that
withdrawal phenomena commonly occur after patients stop taking
benzodiazepines and that they are more frequent after discontinuation of
treatment with shorter-acting drugs.
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