Pharmacologic strategies for discontinuing benzodiazepine treatment

Benzodiazepines have been shown to have broad-spectrum activity, rapid onse t of action, and a wide therapeutic window compared with other anxiolytic m edications. Yet the use of benzodiazepines has been Limited by concern rega rding dependence, withdrawal, and abuse. Agents such as antidepressants, se rotonergic anxiolytics, anticonvulsants, and P-blockers have been used with varying degrees of success to help facilitate the tapering of benzodiazepi nes. Carbamazepine, imipramine, valproate, and trazodone have been benefici al in the management of benzodiazepine discontinuation, but not in decreasi ng the severity of benzodiazepine withdrawal, A stepwise approach to discon tinuing benzodiazepines is offered.