Rickels K, Case W G, Schweizer E, Garcia-Espana F, Fridman R
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia.
Am J Psychiatry. 1991 Jun;148(6):757-61. doi: 10.1176/ajp.148.6.757.
Clinical status and use of benzodiazepines and other psychotropic drugs at follow-up were assessed in patients who had been chronically dependent on benzodiazepines and had been referred for participation in a discontinuation study.
Of 123 benzodiazepine-dependent patients screened for entry into a tapered discontinuation program, 48 had completed the program, 38 had not, and 37 had not undergone drug tapering. Follow-up information was obtained through a structured telephone interview and a mail questionnaire that included a global severity scale assessing anxiety and depression and the Hopkins Symptom Checklist. The time to follow-up was 2.7-5.0 years, and the mean +/- SD interval between screening and follow-up was 2.9 +/- 0.9 years.
Outcome at follow-up significantly favored the patients who had completed the discontinuation program; 73% were not using benzodiazepines, compared to 39% in the unsuccessful taper group and 14% in the no-taper group. Moderate or marked anxiety was still reported by 35% of the patients who were taking benzodiazepines and 25% of those who were not. At follow-up, 22% of the patients were being treated with nonbenzodiazepine psychotropic agents, primarily antidepressants.
The high percentage of patients who were benzodiazepine-free at follow-up and the continued anxiety and depression present in many patients suggest that some patients may have been taking benzodiazepines because of chronic or recurrent anxiety or depression, not physical dependence.
对长期依赖苯二氮䓬类药物且被转介参与停药研究的患者在随访时的临床状况以及苯二氮䓬类药物和其他精神药物的使用情况进行评估。
在123名被筛选进入逐渐减量停药计划的苯二氮䓬类药物依赖患者中,48名完成了该计划,38名未完成,37名未进行药物减量。通过结构化电话访谈和邮寄问卷获取随访信息,问卷包括评估焦虑和抑郁的总体严重程度量表以及霍普金斯症状清单。随访时间为2.7 - 5.0年,筛选与随访之间的平均间隔时间为2.9 ± 0.9年。
随访结果明显有利于完成停药计划的患者;73%的患者未使用苯二氮䓬类药物,相比之下,减量不成功组为39%,未减量组为14%。仍在服用苯二氮䓬类药物的患者中有35%以及未服用的患者中有25%报告有中度或明显焦虑。在随访时,22%的患者正在接受非苯二氮䓬类精神药物治疗,主要是抗抑郁药。
随访时未使用苯二氮䓬类药物的患者比例很高,且许多患者仍存在焦虑和抑郁,这表明一些患者服用苯二氮䓬类药物可能是因为慢性或复发性焦虑或抑郁,而非身体依赖。