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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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