Melatonin facilitates tranquilizer withdrawal

Researchers at Tel-Aviv University report that supplementation with melatonin is very effective in helping people withdraw from tranquilizers and improve their sleep quality.Benzodiazepines such as alprazolam (Xanax), lorazepam (Ativan), oxazepam (Serax), and diazepam (Valium) are the most frequently used drugs for the treatment of insomnia particularly among the elderly. Benzodiazepines are only supposed to be used for short periods of time as prolonged use can engender psychological dependency, impair memory, and ultimately lead to further sleep disturbances. Nevertheless, many people use them continually and have a very difficult time discontinuing them.

Their study involved 34 mostly elderly subjects (mean age of 68 years, range of 40 to 90 years) who were divided into two groups. The active treatment group received 2 mg of controlled-release melatonin two hours before bedtime, while the control group received a placebo. All participants were encouraged to reduce their usual benzodiazepine dosage by 50 per cent in the second week of the experiment, by 75 per cent during weeks three and four, and to completely eliminate the drug during weeks five and six. At the end of week six, 14 out of 18 participants (78 per cent) in the melatonin group had successfully discontinued the use of benzodiazepines and also reported a significantly improved quality of sleep. In the placebo group only four out of 16 participants (25 per cent) had discontinued the drug at the end of the sixth week. All participants were given the opportunity to receive melatonin during a subsequent six-week period. Six members of the placebo group were able to withdraw completely during this second trial period. A follow-up assessment of the 24 patients who had discontinued benzodiazepines found that 19 of them were still off the drug and continuing on melatonin while maintaining good sleep quality at the end of a further six-month period.

The researchers conclude that melatonin can help people withdraw from benzodiazepines and improve sleep quality. They point out that melatonin is safe and produces no withdrawal effects. NOTE: This study was partially funded by Neurim Pharmaceuticals Ltd., a manufacturer of time-release melatonin.
Garfinkel, Doron, et al. Facilitation of benzodiazepine discontinuation by melatonin. Archives of Internal Medicine, Vol. 159, November 8, 1999, pp. 2456-60
Bursztajn, Harold J. Melatonin therapy: from benzodiazepine-dependent insomnia to authenticity and autonomy. Archives of Internal Medicine, Vol. 159, November 8, 1999, pp. 2393-95 (editorial)