Trazodone in Benzodiazepine Dependence

BACKGROUND: The authors set forth to test the usefulness of trazodone as an alternative anxiolytic in benzodiazepine-dependent patients. METHOD: Ten benzodiazepine-dependent patients according to DSM-III-R were hospitalized during a 2-4 week period and treated with trazodone (100 mg t.i.d.) while their benzodiazepine intake was progressively tapered; they left the hospital on a regimen of only a 300-mg daily dose of trazodone and were followed as outpatients at monthly intervals. The dose of trazodone was individually adapted according to condition. RESULTS: Very limited withdrawal phenomena occurred during the benzodiazepine taper period; during the 1-year follow-up, all patients remained off benzodiazepines and showed no evidence of abuse of trazodone. The dose of trazodone was significantly reduced to 185 mg (p = .003); the ratings of anxiety and depressive symptoms also significantly improved during follow-up: from 12.3 to 5.4 on the Hamilton Rating Scale for Anxiety (p = .002) and from 11.6 to 4.8 on the Hamilton Rating Scale for Depression (p = .002). CONCLUSION: These findings suggest the usefulness of trazodone as an alternative anxiolytic in patients at risk for benzodiazepine abuse.