Benzodiazepine dependence and withdrawal: a review of the syndrome and its clinical management

The treatment of anxiety has evolved through various phases. Currently, there is a growing recognition that anxiety disorders are frequently chronic and/or recurrent. There is also less optimism than a decade ago that benzodiazepines will be replaced by alternative agents that are not active at the benzodiazepine receptor. Consequently, the understanding and management of benzodiazepine dependence and withdrawal continue to be of some clinical importance. This article briefly reviews the withdrawal syndrome and the pharmacological and patient variables that contribute to it. It then summarizes the various approaches to managing benzodiazepine dependence and withdrawal.