Long-Term Relapse Rates After Successful Discontinuation of Regular, Long-Term Use of Sleeping Pills

March 15, 2005
By Dr. Gregg D. Jacobs

A prior study by Dr. Charles Morin and colleagues found that long-term nightly users of benzodiazepine sleeping pills can successfully discontinue sleeping pill use on both the quantity of benzodiazepine (BZ) use (about a 90% reduction) and frequency of BZ use (about an 80% reduction). A combined cognitive-behavioral therapy (CBT) and medication taper program produced the greatest percentage of patients who were medication-free at post-treatment at 85%, followed by 54% in a CBT alone program and 48% in a medication taper alone group. The reductions in medication were generally well-maintained at long-term follow-up at one year.

In a recent issue of Behavior Research and Therapy (43 (2005), 1-14), Dr. Morin and his colleagues conducted a long-term assessment of relapse rates in the patients who successfully discontinued from BZs. The follow-up assessment was conducted two years after discontinuation of medication in Dr. Morin's prior study that used a combined cognitive-behavioral therapy (CBT) and medication taper program, a CBT alone program, and a medication taper alone group.

The results of this study indicated that, after 24 months, 69% of the CBT group had relapsed on BZ medication use compared to 31% in the medication taper alone group and 33% in the combined group. These results suggest substantial relapse rates after BZ discontinuation with an overall relapse rate of 43% across all three treatment groups over a two year period. The results also suggest that CBT alone, without structured guideline for medication tapering, was the least successful in long-term successful discontinuation of BZs. Prior findings and the present study suggest that, in long-term nightly users of BZs, a combined cognitive-behavioral therapy (CBT) and medication taper program produces the greatest percentage of patients who become medication-free and remain medication free long-term.