Benzodiazepine withdrawal in general practice.

A study of benzodiazepine prescribing in a single-handed general practice was carried out over a period of three months. It seemed that the existing pattern of prescribing was indiscriminate and ineffective, and that repeat prescriptions were poorly controlled. A programme of controlled withdrawal was instituted for patients whose consumption of benzodiazepines was felt to be no longer appropriate. Of 103 patients identified who had been taking benzodiazepines for longer than three months, 78 were entered into the programme. On completion, 45 patients (58 per cent) had discontinued benzodiazepines completely, and a further 13 (17 per cent) were taking less than half their original dose. Four patients had failed to reduce consumption at all and two were lost to follow-up. At follow-up between three and five months later, 49 patients (63 per cent) had discontinued benzodiazepines completely and only two had restarted treatment. The median time taken to complete the programme was 3.2 weeks, with 95 per cent of patients completing within six weeks. Withdrawal was generally well tolerated, with a temporary increase in insomnia as the main symptom. Two patients experienced severe symptoms, but both had stopped treatment abruptly.