Pharmacological interventions for benzodiazepine discontinuation in chronic benzodiazepine users.
Pharmacological interventions for benzodiazepine discontinuation in chronic benzodiazepine users.
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DOI：
10.1097/xeb.0000000000000161
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发表时间：
2019-06-01
影响因子：
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通讯作者：
Rowan-Robinson, Kate
中科院分区：
文献类型：
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作者：
Rowan-Robinson, Kate
苯二氮卓类药物是治疗失眠和焦虑的有效药物干预，也是预防和治疗癫痫发作的有效药物。1，2虽然苯二氮卓类药物适用于此类疾病的短期管理，但其使用可能会延长，导致个体的药物依赖。3个人可能故意滥用苯二氮卓类药物，或无意中在身体和/或心理上产生依赖。2目前，鼓励处方者向个人提供最低有效剂量，将苯二氮卓类药物的处方限制在4周或更短的使用时间内，并考虑处方中个人的依赖风险。1成为苯二氮卓类药物依赖性慢性使用者的个人可能会出现流感样疾病和肌肉痉挛等身体症状，以及易怒和失眠等心理症状。通常，戒断症状与苯二氮卓类药物处方的原始主诉症状相似，导致反弹症状的夸大效应。这使得苯二氮卓类药物的停药变得复杂，因为人们错误地认为需要继续开处方。2为了帮助患者停止长期使用苯二氮卓类药物，建议逐步戒断、心理支持和药物干预。1科克伦综述旨在评估药物干预促进慢性苯二氮卓类药物停用的益处和危害。本综述的作者研究了药物干预是否有助于停用苯二氮卓类药物。药物干预的重点是戒断症状的管理;然而，目前没有药物，
Benzodiazepines are an effective pharmacological intervention for the management of insomnia and anxiety, and also the prevention and treatment of epileptic seizures. 1, 2 While benzodiazepines are indicated for the short-term management of such conditions, their use may become prolonged, leading to drug dependence in an individual. 3 Individuals may deliberately abuse benzodiazepines, or inadvertently become dependent, physically and/or psychologically. 2 Prescribers are, at present, encouraged to provide the lowest effective dose to individuals, limit prescribing benzodiazepines to 4 weeks of use or less and to consider the risks of dependency in the individual being prescribed for. 1 Individuals who become dependent, chronic users of benzodiazepines may experience physical symptoms such as flu-like illness and muscular cramps, and also psychological symptoms such as irritability and insomnia. Often, the symptoms of withdrawal mimic the symptoms of the original complaint that the benzodiazepines were prescribed for, leading to an exaggerated effect of rebound symptoms. This complicates the discontinuation of benzodiazepines as individuals mistakenly believe there is a need for continued prescription. 2 To assist individuals with discontinuing long-term use of benzodiazepines, gradual withdrawal, psychological support and pharmacological intervention are recommended. 1The Cochrane review aims to assess the benefits and harms of pharmacological interventions to facilitate discontinuation of chronic benzodiazepine use. The authors of this review examined whether pharmacological interventions may facilitate the discontinuation of benzodiazepines. Pharmacological interventions are centred on the symptomatic management of withdrawal; however, no drugs are, at present,