A Cochrane review [Abstract] 1 [withdrawn from publication] included 8 studies with a total of 458 subjects. The studies included could not be analysed cumulatively because of heterogeneity of interventions and participants' characteristics. All participants received a stable dose of benzodiazepine (long acting for most of participants) before starting benzodiazepine discontinuation programs. Progressive withdrawal (over 10 weeks) appeared preferable if compared to abrupt (3 studies, 258 participants) since the number of drop-outs was lower and the procedure judged more favourable by the participants. Short half-life benzodiazepines, associated with higher drop-out rates, did not have higher withdrawal symptoms scores (1 study, 68 patients). Switching from short half-life benzodiazepine to long half-life benzodiazepine before gradual taper withdrawal did not receive support (1 study, 68 patients). 95% of carbamazepine-treated participants were maintained benzodiazepine-free five weeks after taper compared with 62% participants treated with placebo (P < 0.03) (1 study, 55 patients). This statistically significant difference disappeared at 12-week follow-up (74% for carbamazepine group versus 52% for placebo group). No benefits of propranolol (2 studies, 78 patients), dothiepin (a tricyclic antidepressant) (1 study, 87 patients), buspirone (1 study, 24 patients), progesterone (1 study, 43 patients) or hydroxyzine (1 study, 154 patients) were found for managing benzodiazepine withdrawal or abstinence.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes).
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