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Time efficient interventions by general practitioners curb benzodiazepine consumption among long-term users
  1. Cara Tannenbaum
  1. Correspondence to Dr Cara Tannenbaum, Université de Montréal, Faculties of Medicine and Pharmacy, Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, 4545 Queen Mary Road, Suite 4824, Montreal, Quebec, Canada H3W 1W5; cara.tannenbaum{at}umontreal.ca

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What is already known on the topic?

Benzodiazepines increase the risk of cognitive impairment, falls and motor vehicle accidents, so their long-term use is not recommended.1 Many patients are receptive to a trial of withdrawal, and general practitioners (GPs) can be effective catalysts for de-prescription. Evidence is lacking on the most efficient strategy to use in general practice.

What does this paper add?

  • This paper provides level 1 evidence that a 20 min discussion by GPs about the risks of benzodiazepines, alongside provision of a self-applied, written, stepped-dose, tapering protocol results in discontinuation rates of 45% at 1-year in primary care patients without severe comorbidity. This approach is as effective and more time efficient than the same educational intervention plus close monitoring of patients every 2 weeks.

  • Irritability, insomnia, anxiety and tremor may occur transiently during the tapering process.

  • Withdrawal symptoms resolve by 1 year and are no different in frequency to patients who do not receive a discontinuation intervention. …

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