Monday, February 25, 2008

CBT and coming off benzodiazepines

Problems in coming off benzodiazepines can be related to rebound, where the initial problem (e.g. anxiety, sleep problems) is intensified, short-term withdrawal symptoms and re-ocurrence of the original problem for which the medication was originally prescribed. 80% of people who give up benzodiazepines subsequently relapse and even when people are weaned off the drugs gradually a significant number experience distress. For some time there has been a consensus that these problems can benefit from non-medical interventions and psychotherapy and a study of 86 people attempting to withdraw from Benzodiazepines in Montreal compared the effectiveness of cognitive behaviour therapy (CBT) and group therapy. Both were more effective than a control group although CBT did produce higher levels of self-efficacy (people's confidence that they could achieve their goals). Over all 86 participants a high initial level of psychological distress, anxiety and dosage predicted a poor outcome but increase in self-efficacy contributed towards a successful outcome. Although there was a decrease in positive mood during the course of the withdrawal there was no significant increase in negative mood.

O'Connor, Kieron ... [et al] - Cognitive-behavioral, pharmacological and psychosocial predictors of outcome during tapered discontinuation of benzodiazepine Clinical Psychology and Psychotherapy, January-February 2008, 15(1), 1-14

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