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Therapeutics
CBT added to tapering helped patients with chronic insomnia discontinue benzodiazepine use

https://doi.org/10.1136/ebm.9.5.147

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    Morin CM, Bastien C, Guay B, et al. Randomized clinical trial of supervised tapering and cognitive behavior therapy to facilitate benzodiazepine discontinuation in older adults with chronic insomnia. Am J Psychiatry 2004;161:332–42.
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 Q In older patients with both chronic insomnia and long term use of benzodiazepines (BDPs), is cognitive behavioural therapy (CBT) plus supervised medical tapering (SMT) (combined therapy [CT]) more effective than CBT or SMT alone for discontinuing BDPs?

    Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Mental Health ★★★★★☆☆

    METHODS

    Embedded ImageDesign:

    randomised controlled trial.

    Embedded ImageAllocation:

    {allocation concealed*}.†

    Embedded ImageBlinding:

    blinded (technician who scored polysomnography sleep stages).*

    Embedded ImageFollow up period:

    12 months

    Embedded ImageSetting:

    a research based sleep clinic in a university hospital in Sainte-Foy, Québec, Canada.

    Embedded ImagePatients:

    76 patients ⩾55 years of age (mean age 63 y, 50% women) with chronic insomnia (for ⩾6 months), impaired daytime functioning or mood disturbances, and benzodiazepine use (on >50% of nights) for ⩾3 months. Exclusion criteria included medical or psychiatric disorders known to cause insomnia, sleep apnoea, periodic limb movements during …

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    Footnotes

    • ↵* See glossary.

    • ↵† Information provided by author.

    • For correspondence: Dr C M Morin, Université Laval, Sainte-Foy, Québec, Canada. cmorinpsy.ulaval.ca

    • Source of funding: National Institute of Mental Health.