Discontinuation of benzodiazepines among older insomniac adults treated with cognitive-behavioural therapy combined with gradual tapering: a randomized trial

Baillargeon, Lucie; Landreville, Philippe; Verreault, Rene; Beauchemin, Jean-Pierre; Gregoire, Jean-Pierre; Morin, Charles M.
November 2003
CMAJ: Canadian Medical Association Journal;11/11/2003, Vol. 169 Issue 10, p1015
Academic Journal
Background: Long-term use of hypnotics is not recommended because of risks of dependency and adverse effects on health .The usual clinical management of benzodiazepine dependency is gradual tapering, but when used alone this method is not highly effective in achieving long-term discontinuation .We compared the efficacy of tapering plus cognitive-behavioural therapy for insomnia with tapering alone in reducing the use of hypnotics by older adults with insomnia. Methods: People with chronic insomnia who had been taking a Benzedrine every night for more than 3 months were recruited through media advertisements or were referred by their family doctors. They were randomly assigned to undergo either cognitive-behavioural therapy plus gradual tapering of the drug (combined treatment) or gradual tapering only. The cognitive-behavioural therapy was provided by a psychologist in 8 weekly small-group sessions. The tapering was supervised by a physician, who met weekly with each participant over an 8-week period. The main outcome measure was benzodiazepine discontinuation, confirmed by blood screening performed at each of 3 measurement points (immediately after completion of treatment and at 3- and 12-month follow-ups).Results: Of the 344 potential participants, 65 (mean age 67.4 years) met the inclusion criteria and entered the study. The 2 study groups (35 subjects in the combined treatment group and 30 in the tapering group) were similar in terms of demographic characteristics, duration of insomnia and hypnotic dosage. Immediately after completion of treatment, a greater proportion of patients in the combined treatment group had withdrawn from benzodiazepine use completely (77% [26/34]v. 38% [11/29]; odds ratio [OR] 5.3, 95% confidence interval[CI] 1.8-16.2; OR after adjustment for initial benzodiazepinedaily dose 7.9, 95% CI 2.4-30.9). At the 12-month follow-up,the favourable outcome persisted (70% [23/33] v. 24% [7/29];OR 7.2, 95% CI 2.4-23.7; adjusted OR 7.6, 95% CI2...


Related Articles

  • zopiclone.  // Royal Society of Medicine: Medicines;2002, p580 

    This article presents information on zopiclone which, a newly introduced hypnotic drug which works in the same way as a benzodiazepine. It can be used for the short-term treatment of insomnia. Administration is oral.

  • I Think (Right), Therefore I Sleep. Sullivan, Dana // O, The Oprah Magazine;Dec2006, Vol. 7 Issue 12, p180 

    The article discusses people who undergo cognitive behavioral therapy (CBT) rest and sleep easier. According to a Norwegian study published in the Journal of the American Medical Association, insomniacs who took a six-week course in CBT not only fell asleep more quickly and spent less time awake...

  • Effets des benzodiazépines sur la performance cognitive et psychomotrice des personnes âgées souffrant d'insomnie. Gagné, Anouk M.; Morin, Charles M. // Canadian Journal on Aging;Winter2000, Vol. 19 Issue 4, p479 

    This study investigates the effects of chronic use of benzodiazepmes (BZ) as hypnotics on the neuropsychological performance of older adults with insomnia. Twenty-one older persons who had used BZ on a chronic basis (average duration = 21.7 years) for their sleep difficulties were enrolled in a...

  • zaleplon.  // Royal Society of Medicine: Medicines;2002, p574 

    This article presents information on the drug zaleplon. This a newly introduced drug which works in the same way as benzodiazepine group of drugs. It can be used for the short-term treatment of insomnia. Administration is oral. Side effects include headache, asthenia, drowsiness, dependence,...

  • Easy on the Sleeping Pills, Says Consumer's Union: Try Behavioral Therapy Instead. Payne, January W. // Behavior Analysis Digest;Winter2007, Vol. 18 Issue 4, p14 

    The article discusses research on sleeping pills. It references a study by January W. Payne published in the August 15, 2006 issue of "Washington Post." According to a report, about 43 million prescriptions for sleeping pills were filled in the U.S. in 2005. The Consumer's Union is recommending...

  • Zolpidem and triazolam do not affect the nocturnal sleep-induced memory improvement. Meléndez, Jaime; Galli, Irina; Boric, Katica; Ortega, Alonso; Zuñiga, Leonardo; Henríquez-Roldán, Carlos; Cárdenas, Ana // Psychopharmacology;Aug2005, Vol. 181 Issue 1, p21 

    Rationale: It is widely accepted that sleep facilitates memory consolidation. Hypnotics (e.g., benzodiazepines), which reportedly increase sleep efficiency but also modify sleep architecture, could affect memory improvement that occurs during sleep. Objectives: The present study examined the...

  • Hypnotic use in a population-based sample of over thirty-five thousand interviewed Canadians. Kassam, Aliya; Patten, Scott B. // Population Health Metrics;2006, Vol. 4, p15 

    Background: As with most medications, benzodiazepine and similar sedative hypnotics (BDZ/ SSH) can produce both beneficial and adverse effects. Pharmacoepidemiological studies have been limited in their capacity to evaluate the relationship between these medications and psychiatric diagnoses in...

  • Medical Sleep Aids. Roberts, Joan E. // Sky & Telescope;Dec2006, Vol. 112 Issue 6, p51 

    The article provides information on several medical sleep aids. The recommended dosage of melatonin is 0.3- to 1-milligram. Antihistamines are not safe to take by persons with high blood pressure, asthma, glaucoma and bladder problems. Benzodiazepines can also produce bad side effects when taken...

  • eszopiclone.  // Davis's Drug Guide for Nurses, 10th edition;2007, p489 

    The article presents a nursing guide to eszopiclone, a sedative/hypnotic drug for the treatment of insomnia. Its mechanism of action and pharmacokinetics are explained. Contraindications for the drug are presented. Its adverse reactions are cited. Nursing implications are also enumerated.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics