TREATMENTS FOR BENZODIAZEPINE DEPENDENCE

苯二氮卓类药物更安全，滥用的可能性也比 他们取代了巴比妥。 然而，依赖性可能发生在慢性 治疗并导致戒断症状，包括焦虑，失眠， 肿瘤，肌肉抽搐，恶心，知觉扭曲 虽然 苯二氮卓类药物被认为是适度的兴奋剂，这种作用可能 联合收割机与戒断症状，以维持进一步的药物服用。 因为 许多戒断症状类似焦虑症，很难知道 停药症状是否代表疾病复发或药物 戒断 此外，由于焦虑症的长期性， 不清楚停药失败或药物使用复发是否代表 成瘾行为或继续药物治疗。 而药理学 与苯二氮卓类药物身体依赖相关的因素已得到充分研究; 与“心理依赖”有关的行为因素很少 在停药治疗中经常被忽略。 拟议的研究解决了可能涉及的行为因素 对苯二氮卓类药物的心理依赖 三项研究检查 患者对苯二氮卓类药物减量和停药的依从性 通过关注与患者焦虑相关的行为因素。 这些 焦虑可能是由原有的障碍或退缩引起的。 反应，但也可能与心理依赖 药 Exp. #1比较了之前的短期稳定治疗 减少剂量，具有长期剂量稳定的效果， 旨在适应患者并安抚其 减少剂量的焦虑。 Exp. #2比较盲态与开放标签 剂量减少期间的药物给药， 减少可以减少预期的焦虑反应。 Exp. #3比较 控制和认知/行为疗法，以检查 帮助患者在剂量减少期间控制焦虑水平，或 中止 所有研究的衡量标准包括客观和 退出、受试者投诉和药物的主观评估 合规 这些研究应该：1）阐明心理依赖在 慢性苯二氮卓类药物使用; 2）有助于优化治疗策略 苯二氮卓类药物依赖; 3）阐明 治疗性药物依赖中持续使用药物; 4）建议 针对其他药物滥用患者群体的干预措施（例如，可卡因 或阿片类药物使用者）也使用苯二氮卓类药物。

Benzodiazepines are safer and have lesser abuse potential than the barbiturates they replaced. However, dependence can occur with chronic therapy and result in withdrawal symptoms including anxiety, insomnia, tumor, muscle twitching, nausea, and perceptual distortions. Although benzodiazepines are considered modest reinforcers, such effects may combine with withdraws symptoms to sustain further drug taking. Because many withdrawal symptoms mimic anxiety disorder, it is difficult to know whether discontinuation symptoms represent disease reemergence or drug withdrawal. Also, because of the chronicity of anxiety disorders, it is not clear whether discontinuation failure or drug use relapse represents addictive behavior or continued pharmacotherapy. Whereas pharmacological factors involved in benzodiazepine physical dependence are well studied; behavioral factors related to "psychological dependence" have been rarely considered and are often ignored in discontinuation treatment. The proposed research addresses behavioral factors presumably involved in psychological dependence on benzodiazepines. Three studies examine patient compliance with benzodiazepine dose reduction and discontinuation by focusing on behavioral factors related to patient anxiety. These anxieties may be caused by an original disorder or by withdrawal reactions, but also may be related to psychological dependence on medication. Exp. #1 compares a short-term stabilization treatment prior to dose reduction with the effects of long-term dose stabilization and maintenance intended to acclimate the patients and appease their anxieties about dose reduction. Exp. #2 compares blind vs. open-label drug administration during dose reductions with the idea that blind dose- reduction may reduce anticipatory anxiety reactions. Exp. #3 compares control and cognitive/behavioral therapies to examine the effects of helping patients manage their anxiety levels during dose reduction or discontinuation. Measures for all studies include objective and subjective assessments of withdrawal, subject complaints, and medication compliance. These studies should: 1) clarify the role of psychological dependence in chronic benzodiazepine use; 2) help to optimize strategies for treating benzodiazepine dependence; 3) clarify behavioral determinants of persistent drug use in therapeutic drug dependence; 4) suggest interventions for other drug abusing patient populations (e.g., cocaine or opioid users) who also use benzodiazepines.