Does cognitive behavioral therapy for anxiety disorders assist the discontinuation of benzodiazepines among patients with anxiety disorders? A systematic review and meta-analysis

Masahiro Takeshima, Tempei Otsubo, 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, Ken Inada, Hiroki Yamada, Toshiaki Kikuchi, Tsukasa Sasaki, Norio WatanabeKazuo Mishima, Yoshikazu Takaesu

Research output: Contribution to journalReview articlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)119-127
Number of pages9
JournalPsychiatry and Clinical Neurosciences
Volume75
Issue number4
DOIs
Publication statusPublished - 2021 Apr

Keywords

  • anxiety disorder
  • anxiolytics
  • benzodiazepines
  • cognitive behavioral therapy
  • meta-analysis

ASJC Scopus subject areas

  • Neuroscience(all)
  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health

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