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A Controlled Trial of Dothiepin and Placebo in Treating Benzodiazepine Withdrawal Symptoms

Published online by Cambridge University Press:  02 January 2018

Peter Tyrer ,
Brian Ferguson ,
Cosmo Hallström ,
Marian Michie ,
Stephen Tyrer ,
Stephen Cooper ,
Richard Caplan  and
Paul Barczak
Peter Tyrer*
Affiliation:
St Charles Hospital, London W10 6DZ
Brian Ferguson
Affiliation:
Stonebridge Research Centre, Carlton Road, Nottingham NG3 2SH
Cosmo Hallström
Affiliation:
Charing Cross Hospital, London W6
Marian Michie
Affiliation:
St Luke's Hospital, Middlesbrough, Cleveland TS4 3AF
Stephen Tyrer
Affiliation:
Prudhoe Hospital, Prudhoe, Northumbria NE42 5NT
Stephen Cooper
Affiliation:
Department of Mental Health, Whitla Medical Building, Queen's University, Belfast BT9 7BL
Richard Caplan
Affiliation:
General Hospital, Glasgow G51 4TF
Paul Barczak
Affiliation:
Peter Hodgkinson Centre, Lincoln County Hospital, Lincoln LN2 5QY
*
Professor Peter Tyrer, St Charles Hospital, London W10 6DZ
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Abstract

Background

The possibility that treatment with tricyclic antidepressants, in the form of dothiepin, might attenuate benzodiazepine withdrawal symptoms was investigated in a double-blind trial.

Method

Eighty-seven non-depressed psychiatric out-patients with putative normal dose benzodiazepine dependence had their benzodiazepines reduced in stepwise amounts of 20% of the original dose for eight weeks. The patients were randomised to receive dothiepin (with dosage increasing to 150 mg/day) or placebo as an aid to withdrawal before benzodiazepine reduction and these drugs were taken for four further weeks before being stopped.

Results

Fewer patients entered and completed the study than expected and a Type II error was possible in the results. Although there was some evidence of withdrawal symptoms being less marked in those patients allocated to dothiepin this was independent of any antidepressant effect as depression scores were lower in the placebo group in the early phase of withdrawal (P<0.01). Of those completing the study, greater satisfaction (P=0.03) was recorded by those who had received dothiepin; no other differences reached statistical significance.

Conclusions

Dothiepin (and by implication other tricyclic antidepressants) might have some value in reducing benzodiazepine withdrawal symptoms but does not aid drug withdrawal.

Type
Papers
Information
The British Journal of Psychiatry , Volume 168 , Issue 4 , April 1996 , pp. 457 - 461
Copyright
Copyright © Royal College of Psychiatrists, 1996 

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