Abstract
ObjectiveThe consumption of benzodiazepines in France has become a public health issue, which has been the subject of many a national report over these last years (HAS, INPES, OPEPS, ANSM…). Since the 1990s, numerous works have pointed out the excessively high level of consumption in psychotropic medication. In 2009, France came second as a European country after Portugal in anxiolytic consumption, and second after Sweden in consumption of hypnotics. Every year, 1 French person out of 5 consumes at least one benzodiazepines or one related molecule. This consumption of anxiolytics is in majority feminine and increases with age. It is also known that the introduction of a treatment by benzodiazepines leads to an average of 7-month continual consumption and for 52 % of those patients an average exposure for a further 2 consecutive years. The HAS Autumn 2007 report reminds people that benzodiazepines intake endangers the risks of falls (grade B), cognitive alteration (grade C) and accidents on the public highway (grade C), whereas when stopping progressively and supervising use of benzodiazepines, it may improve certain cognitive functions. Facing up to this problem, there are very few efficient therapeutic strategies for withdrawal or maintenance in stopping the medicinal consumption. Materials and methodsIn recent studies, balneotherapy has shown its efficacy in treating generalised anxiety disorder. Furthermore, psycho-educative programmes have proved to be efficient in addiction studies to prevent relapse. In this way, the project associating a psycho-educative programme of cognitive and behavioural type with a 3-week spa treatment, validated by experts appeared to be credible. The programme was constituted and set up in 4 out of 5 of the French psychiatric spa resorts. The programme consisted in associating behavioural and cognitive-based therapy, motivational support and relaxation sessions. A psychologist clinician specializing in behavioural and cognitive therapy trained each team. Seventy patients with an average age of 54 years and 9 months took part in the protocol. They were divided up into 9 groups of 6 to 12 patients over the 4 centres. The aim of the study consisted in ensuring a lasting withdrawal from benzodiazepines. At the outcome of the treatment, a longitudinal follow-up was carried out on Day 5, day 30, day 60, day 100, day 180. The methodological assessment of this study was implemented by the ISPED of Bordeaux II. ResultsThe results are still being analysed, but it can already be concluded that the feasibility of setting up such a programme in a spa resort has been shown from the very encouraging incoming results in terms of the objective of withdrawal in 6 months of benzodiazepines. ConclusionsThermal medicine, which may be associated with an undertaking in behavioural and cognitive therapy can well be a therapeutic solution adapted to the taking-in of those with stable chronic dependency to benzodiazepines in particular. This study is the first clinical trial assessing the efficacy of balneotherapy associated with a psycho-educative treatment in withdrawal from benzodiazepines.
Published Version
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