Education Program using Non-Pharmacologic Support during Benzodiazepine Reduction in Patients with Anxiety Disorders
Dependency on benzodiazepines can lead to serious mental and physical health consequences. An inability to cope with stress, lack of resistance, and being unaware of coping skills all attribute to dependency on benzodiazepines and under-utilization of non-pharmacological techniques.
In mental health clinical practice patients still rely on benzodiazepines to manage their anxiety. Therefore supportive programs are needed to assist patients during reduction in benzodiazepines and/or change to other medication regimes. A program was designed for this purpose using non-pharmacologic techniques along with SSRIs to decrease the use of benzodiazepines in patients treated for anxiety in a psychiatric practice.
A prospective one cycle quality improvement study was implemented using non-pharmacologic methods to decrease anxiety in 20 patients diagnosed with an anxiety disorder within a single psychiatric practice. The intervention included four office visits with an educational component on use of techniques designed to decrease anxiety (guided imagery, deep breathing, mindfulness meditation, progressive muscle relaxation, an emotional freedom technique, along with recommendations for exercise and cognitive behavioral therapy). Patients reported changes in their use of benzodiazepines at the end of the four month program along with an evaluation of the techniques.
Of 20 patients who participated all reported that the techniques helped in reducing anxiety. The majority (n=17; 85%) also reported a decrease in the use of benzodiazepines. Cognitive behavioral therapy was seen as beneficial by 11 (55%) of the participants. Participants reported that they preferred exercise and mindfulness meditation as anxiety reducing techniques.
Implementation of an Anxiety Reduction Protocol/program that used non-pharmacologic methods to decrease anxiety was effective in helping to decrease benzodiazepine use. Participants found the program helpful and recommended that the program be extended over a longer time period than the three months scheduled.