Effects of tapering of long-term benzodiazepines on cognitive function in patients with schizophrenia receiving a second-generation antipsychotic

The high use of long-term benzodiazepines (BZDs) with second-generation antipsychotics (SGAs) has been identified as an important issue in the treatment of schizophrenia in Japan. The aim of this study was to evaluate the effects of gradual reduction or discontinuation of daytime BZD use on cognitiv...

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Bibliographic Details
Published in:Progress in neuro-psychopharmacology & biological psychiatry 2012-03, Vol.36 (2), p.300-306
Main Authors: Kitajima, Rei, Miyamoto, Seiya, Tenjin, Tomomi, Ojima, Kazuaki, Ogino, Shin, Miyake, Nobumi, Fujiwara, Keisuke, Funamoto, Yasuyuki, Arai, Jun, Tsukahara, Sachiko, Ito, Yukie, Tadokoro, Masanori, Anai, Kiriko, Kaneda, Yasuhiro, Yamaguchi, Noboru
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adult and adolescent clinical studies
Antipsychotic Agents - therapeutic use
Benzodiazepines
Benzodiazepines - administration & dosage
Benzodiazepines - adverse effects
Benzodiazepines - therapeutic use
Biological and medical sciences
Cognition - drug effects
Cognition Disorders - complications
Cognition Disorders - drug therapy
Cognition Disorders - psychology
Cognitive function
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Humans
Male
Medical sciences
Middle Aged
Neuropharmacology
Neuropsychological Tests - statistics & numerical data
Pharmacology. Drug treatments
Prospective Studies
Psychiatric Status Rating Scales - statistics & numerical data
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses
Quality of life
Quality of Life - psychology
Schizophrenia
Schizophrenia - complications
Schizophrenia - drug therapy
Schizophrenic Psychology
Second-generation antipsychotics
Time Factors
Withholding Treatment
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Summary:The high use of long-term benzodiazepines (BZDs) with second-generation antipsychotics (SGAs) has been identified as an important issue in the treatment of schizophrenia in Japan. The aim of this study was to evaluate the effects of gradual reduction or discontinuation of daytime BZD use on cognitive function and quality of life (QOL) in patients with chronic schizophrenia receiving an SGA. Thirty schizophrenic patients who had received an SGA with concomitant BZDs for at least 3 months were enrolled. Before and 4 weeks after tapering of daytime BZDs, the Brief Assessment of Cognition in Schizophrenia Japanese-language version (BACS-J) and the Schizophrenia Quality of Life Scale Japanese-language version (SQLS-J) were administered. Clinical evaluation also included the Positive and Negative Syndrome Scale (PANSS). To compare for practice effects on the BACS-J, 10 patients with chronic schizophrenia were assessed without tapering BZDs. BZDs were reduced or discontinued safely in most patients, and no emergent withdrawal symptoms were observed. Significant improvements were shown in verbal memory, working memory, and composite score, as measured by the BACS-J without practice effects. In addition, the motivation/energy score on the SQLS-J, the negative symptoms and total scores on the PANSS significantly improved after tapering BZDs. Reduction or discontinuation of long-term daytime use of BZDs may be warranted in patients with schizophrenia treated with SGAs, as it may improve cognitive function, subjective QOL, and psychiatric symptoms with no significant adverse effects. ► The chronic use of benzodiazepines may decrease cognitive function in schizophrenia. ► Daytime benzodiazepines can be gradually tapered without significant adverse effects. ► A reduction of 25–50% of the daily dose per 2–4 weeks may be a safe tapering strategy. ► Reduction or cessation of benzodiazepine use can improve verbal and working memory. ► Tapering of benzodiazepines can improve subjective QOL and psychiatric symptoms.
ISSN:0278-5846
1878-4216
DOI:10.1016/j.pnpbp.2011.11.008