Harvard review of psychiatry · 2026
Inpatient Management of Benzodiazepine Withdrawal: A Narrative Review of a Systematic, Individualized Taper Design.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Karavolis Zoe, Hendler Reuben, Sedgewick Amanda, Mosquera Matthew, McHugh R Kathryn, Kim Jungjin
Аннотация
LEARNING OBJECTIVES: After participating in this CME activity, the psychiatrist should be better able to.
BACKGROUND: Benzodiazepines are widely prescribed, yet long-term use carries risks of adverse clinical outcomes and challenging withdrawal syndromes. Although gradual outpatient tapering remains the standard recommendation for discontinuation, a subset of patients may require more rapid discontinuation in inpatient settings due to complex factors, such as misuse of multiple substances, prior failed tapering attempts, or co-occurring medical and psychiatric conditions.
METHODS: This narrative review synthesizes contemporary literature on inpatient benzodiazepine withdrawal. We conducted a targeted review of clinical studies, guidelines, and expert opinion pieces published from 2000-2024, with a focus on real-world applicability.
DISCUSSION: We assess recent findings and best-practice recommendations on benzodiazepine discontinuation and propose a systematic, individualized tapering strategy to guide inpatient withdrawal management. Additionally, we review medication selection, long-acting benzodiazepines and phenobarbital protocols, adjunctive pharmacotherapy, and behavioral interventions while emphasizing co-occurring disorders, risk management, and protracted withdrawal symptoms.
CONCLUSION: Our proposed approach may enhance systematic and safe management of inpatient benzodiazepine withdrawal, especially for complex patient populations.
BACKGROUND: Benzodiazepines are widely prescribed, yet long-term use carries risks of adverse clinical outcomes and challenging withdrawal syndromes. Although gradual outpatient tapering remains the standard recommendation for discontinuation, a subset of patients may require more rapid discontinuation in inpatient settings due to complex factors, such as misuse of multiple substances, prior failed tapering attempts, or co-occurring medical and psychiatric conditions.
METHODS: This narrative review synthesizes contemporary literature on inpatient benzodiazepine withdrawal. We conducted a targeted review of clinical studies, guidelines, and expert opinion pieces published from 2000-2024, with a focus on real-world applicability.
DISCUSSION: We assess recent findings and best-practice recommendations on benzodiazepine discontinuation and propose a systematic, individualized tapering strategy to guide inpatient withdrawal management. Additionally, we review medication selection, long-acting benzodiazepines and phenobarbital protocols, adjunctive pharmacotherapy, and behavioral interventions while emphasizing co-occurring disorders, risk management, and protracted withdrawal symptoms.
CONCLUSION: Our proposed approach may enhance systematic and safe management of inpatient benzodiazepine withdrawal, especially for complex patient populations.