Abstract
BackgroundBenzodiazepine withdrawal syndrome has been reported following attempts to withdraw even from low or therapeutic doses and has been compared to barbiturate and alcohol withdrawal. This experience is known to deter patients from future cessation attempts. Research on other psychotropic substances shows that the reasons and motivations for withdrawal attempts – as well as the experiences surrounding those attempts – at least partially predict future efforts at discontinuation as well as relapse. We therefore aimed to qualitatively explore what motivates patients to discontinue this medication as well as to examine their experiences surrounding previous and current withdrawal attempts and treatment interventions in order to positively influence future help-seeking behavior and compliance.MethodsTo understand these patients better, we conducted a series of 41 unstructured, narrative, in-depth interviews among adult Swiss patients with a long-term dependent use of benzodiazepines in doses equivalent to more than 40 mg diazepam per day and/or otherwise problematic use (mixing benzodiazepines, escalating dosage, recreational use or illegal purchase). Mayring’s qualitative content analysis was used to evaluate findings.ResultsThese high-dose benzodiazepine-dependent patients decision to change consumption patterns were affected by health concerns, the feeling of being addicted and social factors. Discontinuation attempts were frequent and not very successful with fast relapse. Withdrawal was perceived to be a difficult, complicated, and highly unpredictable process. The first attempt at withdrawal occurred at home and typically felt better than at the clinic. Inpatient treatment was believed to be more effective with long term treatment (approaches) than short term.Patients preferred gradual reduction of usage to abrupt cessation (and had experienced both). While no clear preferences for withdrawal were found for benzodiazepines with specific pharmacokinetic properties, participants frequently based their decision to participate in treatment on the availability of their preferred brand name and furthermore discarding equivalent dosage rationales.ConclusionsOur findings provide greater understanding of the factors that motivate high-dose benzodiazepine-dependent individuals to stop taking these medications, and how they experience withdrawal and treatment strategies. They underscore how patients’ perceptions of treatment approaches contribute to compliant or non-compliant behavior.
Highlights
Benzodiazepine withdrawal syndrome has been reported following attempts to withdraw even from low or therapeutic doses and has been compared to barbiturate and alcohol withdrawal
Some 20 - 50% of BZD users are believed to experience some sort of withdrawal when trying to discontinue BZD after extended use, indicating signs of dependence [8,9]
Matters are further complicated by a heterogeneous use of the term within the scientific community: Some authors differentiate between high-dose dependence that results from long-term prescription abuse following treatment of an underlying condition, and high-dose dependence that is a consequence of BZD use for recreational purposes [11,12]
Summary
Benzodiazepine withdrawal syndrome has been reported following attempts to withdraw even from low or therapeutic doses and has been compared to barbiturate and alcohol withdrawal This experience is known to deter patients from future cessation attempts. Benzodiazepine withdrawal syndrome has been reported following attempts to withdraw even from low or therapeutic doses [12,17], and has been compared to barbiturate and alcohol withdrawal [18,19,20] It has repeatedly been associated with symptoms that can range from anxiety, panic attacks, sleep disorders, cognitive impairments, and muscle spasms, to perceptual hypersensitivity, depersonalization, hallucinations, excitability, symptoms of psychosis, and convulsions [20,21]. Some researchers have called for investigation of long-term and/or high-dose users in relation to evaluating discontinuation of treatment [15,24,25]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.