Management of benzodiazepine dependence and toxicity.

The key target of this review is to compare the efficacies of the different adjuncts and methods used in the management of benzodiazepine dependence (tolerance and withdrawal) and poisoning. A systemic review of randomized controlled trials was carried out to determine which method of adjuvant therapy can be best used to overcome the withdrawal symptoms exhibited during benzodiazepine discontinuation. In addition, different tapering methods employed have also been presented in this review. Zolpidem in combination with cognitive behavioural therapy with a parallel gradual taper after conversion to long half-life Benzodiazepine seems to be a promising method among the several analysed. Finally the efficacies of the two available methods to combat benzodiazepine toxicity, namely flumazenil and naloxone have been discussed and compared.