Hypnotic Withdrawal Programme

Section Progress

Hypnotic withdrawal

Many patients are keen to withdraw from long term hypnotic treatment but are unable to do so because of withdrawal syndromes.

There is a great deal of information on hypnotic withdrawal programmes based on the work of Professor Heather Ashton and colleagues.

There is good evidence that a minimal intervention such as a tailored personalised letter from the GP or a consultation with the GP to explain why and how to come off hypnotic drugs can be effective. 

Gradual withdrawal if possible for most patients and the use of psychological support and treatments (CBTi) together with tapering off medication has been shown to improve sleep and quality of life. This approach is more likely to improve sleep than maintaining patients on their sleeping tablets while providing CBTi while.

Short acting drugs such as temazepam or z-drugs may need to be reduced to the lowest available dose and then converted to equivalent doses of diazepam to facilitate gradual withdrawal.


References

Voshaar RC, Couvee JE, van Balkom AJ, Mulder PG, Zitman FG. Strategies for discontinuing long-term benzodiazepine use: meta-analysis. Br J Psychiatry 2006, 189: 213-220
Morin CM, Vallieres A, Guay B, Ivers H, Savard J, Merette C et al. Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA 2009, 301: 2005-2015.