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The British Journal of Psychiatry (2003) 182: 498-504
© 2003 The Royal College of Psychiatrists

Tapering off long-term benzodiazepine use with or without group cognitive–behavioural therapy: three-condition, randomised controlled trial

RICHARD C. OUDE VOSHAAR, MD, WIM J. M. J. GORGELS, MD and AUDREY J. J. MOL, MA

University Medical Centre, Nijmegen, The Netherlands

ANTON J. L. M. VAN BALKOM, MD

Amsterdam Free University, The Netherlands

ELOY H. VAN DE LISDONK, MD, MARINUS H. M. BRETELER, PhD and HENK J. M. VAN DEN HOOGEN

University of Nijmegen, The Netherlands

FRANS G. ZITMAN, PhD

Leiden University, The Netherlands

Correspondence: R.C. Oude Voshaar,University Medical Centre St Radboud, Department of Psychiatry (hp 333), PO Box 9101, 6500 HB Nijmegen,The Netherlands. Tel: 24 3613489; fax: 24 3540561; e-mail: r.oudevoshaar{at}psy.umcn.nl

Declaration of interest None.The study was funded by the Dutch Health Care Insurance Council.

Background Benzodiazepine withdrawal programmes have never been experimentally compared with a nonintervention control condition.

Aims To evaluate the efficacy and feasibility of tapering off long-term benzodiazepine use in general practice, and to evaluate the value of additional group cognitive–behavioural therapy (CBT).

Method A 3-month randomised, 3-month controlled trial was conducted in which 180 people attempting to discontinue long-term benzodiazepine use were assigned to tapering off plus group CBT, tapering off alone or usual care.

Results Tapering off led to a significantly higher proportion of successful discontinuations than usual care (62% . 21%). Adding group CBT did not increase the success rate (58% v. 62%).Neither successful discontinuation nor intervention type affected psychological functioning. Both tapering strategies showed good feasibilityin general practice.

Conclusions Tapering off is a feasible and effective way of discontinuing long-term benzodiazepine use in general practice.The addition of group CBT is of limited value.

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