Petrovic M, Pevernagie D, Van Den Noortgate N, Mariman A, Michielsen W, Afschrift M
Service of Internal Medicine, University Hospital, Ghent, Belgium.
Int J Geriatr Psychiatry. 1999 Sep;14(9):754-60.
We tested the hypothesis that a short-term programme for withdrawal of benzodiazepines (BZD) is feasible in hospitalized geriatric patients.
Fifty-six geriatric subjects who had been taking BZD for at least 3 months were asked to discontinue these drugs upon admission to the inpatient ward. A withdrawal programme including initial substitution therapy combined with psychological consulting was offered. The usual BZD medication was replaced by either lormetazepam 1 mg or trazodone 50 mg, administered at bedtime. After 1 week of replacement therapy all sedative medication was stopped. The subjective estimations of sleep quality were evaluated four times during a period of 6 weeks.
Forty-nine patients agreed to participate. In this group four subjects (8.2%) resumed BZD use while in the hospital and another seven subjects (14.3%) relapsed after discharge. Therefore, the overall success rate was 77.6% in the group of volunteers and 67. 9% in the total group of eligible patients. The data of the present study further demonstrate that no major withdrawal symptoms occurred and that the subjective quality of sleep remained virtually unchanged in the course of the programme. The sleep quality was not significantly different in patients on trazodone versus patients on lormetazepam. The success rate was similar in both drug substitution groups.
Short-term withdrawal of BZD may be achieved in two-thirds of elderly hospital inpatients without deterioration of sleep quality or other deleterious side-effects.
我们检验了以下假设，即针对住院老年患者的短期苯二氮䓬类药物（BZD）戒断方案是可行的。
56名服用BZD至少3个月的老年受试者在入住 inpatient ward时被要求停用这些药物。提供了一个包括初始替代疗法并结合心理咨询的戒断方案。常规的BZD药物被1毫克氯美扎酮或50毫克曲唑酮替代，于睡前服用。替代疗法1周后，停用所有镇静药物。在6周的时间内对睡眠质量的主观评估进行了4次。
49名患者同意参与。在该组中，4名受试者（8.2%）在住院期间恢复使用BZD，另外7名受试者（14.3%）在出院后复发。因此，志愿者组的总体成功率为77.6%， eligible patients的总组为67.9%。本研究的数据进一步表明，未出现严重的戒断症状，且在方案实施过程中睡眠的主观质量基本保持不变。服用曲唑酮的患者与服用氯美扎酮的患者的睡眠质量无显著差异。两个药物替代组的成功率相似。
三分之二的老年住院患者可以实现BZD的短期戒断，且睡眠质量不会恶化或出现其他有害副作用。
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