TY - JOUR
T1 - Does cognitive behavioral therapy for anxiety disorders assist the discontinuation of benzodiazepines among patients with anxiety disorders? A systematic review and meta-analysis
AU - Takeshima, Masahiro
AU - Otsubo, Tempei
AU - Funada, Daisuke
AU - Murakami, Maki
AU - Usami, Takashi
AU - Maeda, Yoshihiro
AU - Yamamoto, Taisuke
AU - Matsumoto, Toshihiko
AU - Shimane, Takuya
AU - Aoki, Yumi
AU - Otowa, Takeshi
AU - Tani, Masayuki
AU - Yamanaka, Gaku
AU - Sakai, Yojiro
AU - Murao, Tomohiko
AU - Inada, Ken
AU - Yamada, Hiroki
AU - Kikuchi, Toshiaki
AU - Sasaki, Tsukasa
AU - Watanabe, Norio
AU - Mishima, Kazuo
AU - Takaesu, Yoshikazu
N1 - Funding Information:
This study was supported by research grants from the Japanese Ministry of Health, Labour, and Welfare (H29‐Seishin‐Ippan‐001 and 19GC1012).
Funding Information:
Daisuke Funada, Maki Murakami, Takashi Usami, Yoshihiro Maeda, Taisuke Yamamoto, Toshihiko Matsumoto, Takuya Shimane, Yumi Aoki, Takeshi Otowa, Masayuki Tani, Gaku Yamanaka, Yojiro Sakai, Tomohiko Murao, Hiroki Yamada, and Norio Watanabe declare no conflict of interest. Masahiro Takeshima has received personal fees from Daiichi Sankyo Company and Meiji Seika; and grants from SHIONOGI & CO., LTD., Otsuka Pharmaceutical, and Eisai, outside the submitted work. Tempei Otsubo has received personal fees from Eli Lily, Takeda Pharmaceutical, Otsuka Pharmaceutical, Yoshitomi Yakuhin, Sumitomo Dainippon Pharma, Mochida, Meiji Seika Pharma, and Kyowa Pharmaceutical; and grants from Eisai and Otsuka Pharmaceutical, outside the submitted work. Ken Inada has received personal fees from Dainippon Sumitomo Pharma Co., Ltd., Mochida Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Novartis Pharma K.K, Meiji Seika Pharma Co., Ltd., Shionogi & Co., Ltd., Eli Lilly Japan K.K., Astellas Pharma Inc., Otsuka Pharmaceutical, Co., Ltd., Chugai Pharmaceutical Co., Ltd., Lundbeck Japan K.K., Eisai Co., Ltd., and Janssen Pharmaceutical K.K.; and grants and personal fees from MSD K.K. and Mitsubishi Tanabe Pharma Co., outside the submitted work. Toshiaki Kikuchi has received personal fees from Dainippon, Pfizer, Takeda, Eli Lilly, Mochida, Lundbeck, Otsuka, Kyowa Hakko Kirin, Meiji, Yoshitomi Yakuhin, and MSD, outside the submitted work. Tsukasa Sasaki has received personal fees from Mochida Pharmaceutical, outside the submitted work. Kazuo Mishima has received grants from the Japanese Ministry of Health, Labour, and Welfare and Eisai Co., Ltd., during the conduct of the study; personal fees from MSD Inc.; grants and personal fees from Mitsubishi Tanabe Pharma Corporation (Yoshitomiyakuhin Corporation), Takeda Pharmaceutical Co., Ltd., Nobelpharma Co., Ltd., and Otsuka Pharmaceutical Co., Ltd.; and personal fees from Astellas Pharma Inc. and Pfizer Inc., outside the submitted work. Yoshikazu Takaesu has received grants and personal fees from Otsuka Pharmaceutical, Meiji Seika, MSD, and Eisai; and personal fees from Eli Lilly, Mitsubishi Tanabe Pharma, Yoshitomi Pharmaceutical and Takeda Pharmaceutical, outside the submitted work.
Publisher Copyright:
© 2021 The Authors Psychiatry and Clinical Neurosciences published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology
PY - 2021/4
Y1 - 2021/4
N2 - Long-term use of benzodiazepines (BZD) is not recommended for the treatment of anxiety disorders. Cognitive behavioral therapy (CBT) is an effective treatment option for discontinuation of BZD in patients with anxiety disorders. This systematic review and meta-analysis sought to clarify whether CBT is effective for discontinuing BZD anxiolytics in patients with anxiety disorders. This study was preregistered with PROSPERO (registration number: CRD42019125263). A literature search of major electronic databases was conducted in December 2018. Three randomized controlled trials were included in this review, and meta-analyses were performed. The proportion of discontinuing BZD anxiolytics was significantly higher in the CBT plus gradual tapering group than in the gradual tapering alone group, both in the short term (3 months after allocation; number needed to treat: 3.2, 95% confidence interval [CI]: 2.1 to 7.1; risk ratio: 1.96, 95%CI: 1.29 to 2.98, P = 0.002, three studies) and long term (6 to 12 months after allocation; number needed to treat: 2.8, 95%CI: 1.9 to 5.3; risk ratio: 2.16, 95%CI: 1.41 to 3.32, P = 0.0004, three studies). CBT may be effective for discontinuing BZD anxiolytics, both in the short term and in the long term after the allocation. Further studies with larger sample sizes are necessary to draw definitive conclusions regarding the efficacy and safety of CBT for discontinuing BZD anxiolytics in patients with anxiety disorders.
AB - Long-term use of benzodiazepines (BZD) is not recommended for the treatment of anxiety disorders. Cognitive behavioral therapy (CBT) is an effective treatment option for discontinuation of BZD in patients with anxiety disorders. This systematic review and meta-analysis sought to clarify whether CBT is effective for discontinuing BZD anxiolytics in patients with anxiety disorders. This study was preregistered with PROSPERO (registration number: CRD42019125263). A literature search of major electronic databases was conducted in December 2018. Three randomized controlled trials were included in this review, and meta-analyses were performed. The proportion of discontinuing BZD anxiolytics was significantly higher in the CBT plus gradual tapering group than in the gradual tapering alone group, both in the short term (3 months after allocation; number needed to treat: 3.2, 95% confidence interval [CI]: 2.1 to 7.1; risk ratio: 1.96, 95%CI: 1.29 to 2.98, P = 0.002, three studies) and long term (6 to 12 months after allocation; number needed to treat: 2.8, 95%CI: 1.9 to 5.3; risk ratio: 2.16, 95%CI: 1.41 to 3.32, P = 0.0004, three studies). CBT may be effective for discontinuing BZD anxiolytics, both in the short term and in the long term after the allocation. Further studies with larger sample sizes are necessary to draw definitive conclusions regarding the efficacy and safety of CBT for discontinuing BZD anxiolytics in patients with anxiety disorders.
KW - anxiety disorder
KW - anxiolytics
KW - benzodiazepines
KW - cognitive behavioral therapy
KW - meta-analysis
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U2 - 10.1111/pcn.13195
DO - 10.1111/pcn.13195
M3 - Review article
C2 - 33448517
AN - SCOPUS:85101507660
SN - 1323-1316
VL - 75
SP - 119
EP - 127
JO - Psychiatry and Clinical Neurosciences
JF - Psychiatry and Clinical Neurosciences
IS - 4
ER -
