Management of benzodiazepine dependence.

Dependence is a recognized problem in a significant number of patients taking therapeutic doses of benzodiazepines. A characteristic withdrawal syndrome has been described. These patients are best managed as outpatients with gradual dosage reduction over 4-12 weeks. Pharmacological adjuncts such as propranolol and non-benzodiazepine hypnotics are useful for certain specific symptoms, but so far no single substance has proved useful in attenuating the majority of symptoms. Psychological and social support should be maximized, but here again no single technique has been shown to be more than moderately successful. The best treatment is thoughtful prescribing ab initio.