The dependence potential of short half-life benzodiazepines: a meta-analysis.

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Abstract
OBJECTIVES. The dependence potential of benzodiazepine medications is now widely recognized, but uncertainty exists as to whether use of short half-life vs long half-life drugs results in greater dependence. The present study reports a meta-analysis of the extant research to evaluate the dependence potential of different types of benzodiazepines. METHOD. Seven studies were found that specifically compared long half-life and short half-life benzodiazepines and allowed statistical comparison by their homogeneous dependent variables. Drugs in these studies were used as daytime sedatives. RESULTS. Substantial evidence was found for differential effects of short vs long half-life drugs at withdrawal. In all studies, dropouts were higher among short half-life subjects. In the random-assignment short-term use studies, Hamilton Anxiety Scale scores showed higher incidence of rebound among subjects who used the short half-life drugs. CONCLUSIONS. The present meta-analysis confirms clinical impressions of the greater dependence potential of short vs long half-life benzodiazepines. Doctors, patients, and policymakers need to be informed so as to avoid harm to the public health through unintended drug dependence.