Background: Long-term benzodiazepine (BZD) use is not recommended for treating anxiety disorders. However, in clinical practice, BZD anxiolytics are often used for the long-term treatment of anxiety disorders. This systematic review and meta-analysis aimed to clarify the effectiveness of cognitive behavioral therapy (CBT) for discontinuing BZD anxiolytics in patients with anxiety disorders.
Methods: This study was preregistered with PROSPERO (registration number: CRD42019125263). A literature search of major electronic databases was conducted in December 2018.
Results: Three randomized controlled trials were included in this review, and meta-analyses were performed. The rate of discontinuing BZD anxiolytics was significantly higher in the CBT plus gradual tapering group than in the gradual tapering alone group at 3 months (risk ratio: 1.96,95% confidence interval: 1.29 to 2.98, P=0.002, three studies) and 6 to 12 months after allocation (risk ratio: 2.16,95% confidence interval: 1.41 to 3.32, P=0.0004, three studies).
Conclusion: CBT may be effective for discontinuing BZD anxiolytics in the short and long term after allocation. Further studies with larger sample sizes are warranted to clarify definitive conclusions regarding the efficacy and safety of CBT for discontinuing BZD anxiolytics in patients with anxiety disorders.
Authors' abstract
Cognitive Behavioral Therapy for Benzodiazepine Discontinuation among Patients with Anxiety Disorders: A Systematic Review and Meta-analysis
1 Department of Neuropsychiatry, Akita University Graduate School of Medicine
2 Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus
2 Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus
Psychiatria et Neurologia Japonica
124: 285-292, 2022
<Keywords:anxiety disorder, anxiolytics, benzodiazepine, cognitive behavioral therapy, meta-analysis>