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II. Effects of Gradual Taper

Edward Schweizer, MD; Karl Rickels, MD; W. George Case, MD; David J. Greenblatt, MD

Arch Gen Psychiatry. 1990;47(10):908-915.

Abstract
• We compared the effect on withdrawal severity and acute outcome of a 25% per week taper of short half-life vs long half-life benzodiazepines in 63 benzodiazepine-dependent patients. Patients unable to tolerate taper were permitted to slow the taper rate. Ninety percent of patients experienced a withdrawal reaction, but it was rarely more than mild to moderate. Nonetheless, 32% of long half-life and 42% of short half-life benzodiazepinetreated patients were unable to achieve a drug-free state. The most difficulty was experienced in the last half of taper. Baseline personality, high Eysenck neuroticism, female sex, and mild-tomoderate alcohol use were found to be more significant predictors of withdrawal severity than the daily benzodiazepine dose or benzodiazepine half-life. These findings suggest that personality factors contribute significantly to the patient's difficulties with gradual benzodiazepine discontinuation of therapeutic doses of benzodiazepines.

Footnotes
Accepted for publication November 29, 1989.

From the Psychopharmacology Research Unit, Department of Psychiatry, University of Pennsylvania, Philadelphia (Drs Schweizer, Rickels, and Case), and the Division of Clinical Pharmacology, Departments of Psychiatry and Pharmacology, Tufts University School of Medicine and New England Medical Center, Boston, Mass (Dr Greenblatt).

Reprint requests to 203 Piersol Bldg, University Hospital, 3400 Spruce St, Philadelphia, PA 19104 (Dr Rickels).

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