A Controlled Trial of Dothiepin and Placebo in Treating Benzodiazepine Withdrawal Symptoms

The possibility that treatment with tricyclic antidepressants, in the form of dothiepin, might attenuate benzodiazepine withdrawal symptoms was investigated in a double-blind trial. Eighty-seven non-depressed psychiatric out-patients with putative normal dose benzodiazepine dependence had their benz...

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Bibliographic Details
Published in:British journal of psychiatry 1996-04, Vol.168 (4), p.457-461
Main Authors: Tyrer, Peter, Ferguson, Brian, Hallström, Cosmo, Michie, Marian, Tyrer, Stephen, Cooper, Stephen, Caplan, Richard, Barczak, Paul
Format: Article
Language:English
Subjects:
Ambulatory Care
Anti-Anxiety Agents - adverse effects
Antidepressants
Antidepressive Agents, Tricyclic - therapeutic use
Benzodiazepines
Dosage
Dose-Response Relationship, Drug
Dothiepin - therapeutic use
Double-Blind Method
Drug Administration Schedule
Drug withdrawal
Humans
Mental depression
Mental disorders
Neurologic Examination - drug effects
Patient Satisfaction
Substance Withdrawal Syndrome - drug therapy
Treatment Outcome
Tricyclic antidepressants
Withdrawal
Withdrawal symptoms
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Summary:The possibility that treatment with tricyclic antidepressants, in the form of dothiepin, might attenuate benzodiazepine withdrawal symptoms was investigated in a double-blind trial. Eighty-seven non-depressed psychiatric out-patients with putative normal dose benzodiazepine dependence had their benzodiazepines reduced in stepwise amounts of 20% of the original dose for eight weeks. The patients were randomised to receive dothiepin (with dosage increasing to 150 mg/day) or placebo as an aid to withdrawal before benzodiazepine reduction and these drugs were taken for four further weeks before being stopped. Fewer patients entered and completed the study than expected and a Type II error was possible in the results. Although there was some evidence of withdrawal symptoms being less marked in those patients allocated to dothiepin this was independent of any antidepressant effect as depression scores were lower in the placebo group in the early phase of withdrawal (P < 0.01). Of those completing the study, greater satisfaction (P = 0.03) was recorded by those who had received dothiepin; no other differences reached statistical significance. Dothiepin (and by implication other tricyclic antidepressants) might have some value in reducing benzodiazepine withdrawal symptoms but does not aid drug withdrawal.
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.168.4.457