A CONTROLLED TRIAL OF DOTHIEPIN AND PLACEBO IN TREATING BENZODIAZEPINE WITHDRAWAL SYMPTOMS

Background. The possibility that treatment with tricyclic antidepressa nts, in the form of dothiepin, might attenuate benzodiazepine withdraw al symptoms was investigated in a double-blind trial. Method. Eighty-s even non-depressed psychiatric out-patients with putative normal dose benzodiazepine dependence had their benzodiazepines reduced in stepwis e amounts of 20% of the original dose for eight weeks. The patients we re randomised to receive dothiepin (with dosage increasing to 150 mg/d ay) or placebo as an aid to withdrawal before benzodiazepine reduction and these drugs were taken for four further weeks before being stoppe d. Results. Fewer patients entered and completed the study than expect ed and a Type II error was possible in the results. Although there was some evidence of withdrawal symptoms being less marked in those patie nts allocated to dothiepin this was independent of any antidepressant effect as depression scores were lower in the placebo group in the ear ly phase of withdrawal (P < 0.01). Of those completing the study, grea ter satisfaction (P=0.03) was recorded by those who had received dothi epin; no other differences reached statistical significance. Conclusio ns. Dothiepin (and by implication other tricyclic antidepressants) mig ht have some value in reducing benzodiazepine withdrawal symptoms but does not aid drug withdrawal.