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June 8, 1984

Withdrawal From Benzodiazepines

Author Affiliations

St Louis University School of Medicine

JAMA. 1984;251(22):2928. doi:10.1001/jama.1984.03340460018010

To the Editor.—  I read with interest the recent report in The Journal by Conell and Berlin1 on withdrawal reactions associated with chronic benzodiazepine use and wish to make the following comments. While the routine monitoring of blood levels of benzodiazepines is not warranted, I believe that when a patient has a history of chronic intake of a benzodiazepine plus a history of symptoms suggesting a withdrawal state or overuse of medication, ie, restlessness, difficulty concentrating, or irritability, obtaining a benzodiazepine level may be helpful in the clinical treatment of the patient. I recently treated a patient with a similar history as the first case in Conell and Berlin's report. The patient had been taking clorazepate from her physician for more than four years but had initially minimized her dosage and the duration of ingestion of it. A blood level determination helped solve the perplexing clinical state of my