A review of adjunctive antiseizure medicines found small and inconsistent studies. Short-term symptom improvement did not reliably establish durable benzodiazepine discontinuation.
The evidence reviewed
Dueno and colleagues included 21 reports spanning trials, observational studies, and case reports or series. They examined carbamazepine, oxcarbazepine, valproate, gabapentinoids, and other proposed adjuncts to tapering.
One small carbamazepine trial reported 74% benzodiazepine-free at three months versus 52% with placebo. Other results differed by population, timing, and endpoint. An oxcarbazepine report lacked a control group, and evidence for several alternatives was sparse.
Design differences limit a ranking
Some studies began benzodiazepine treatment at enrollment and later tapered it, which differs from treating people dependent after years of use. Other studies started the adjunct at different points relative to the taper. Those designs answer related but distinct questions.
Small samples, varying baseline drugs, and inconsistent withdrawal and cessation measures limited synthesis. The review did not establish one regimen that safely prevents all seizures or ensures long-term abstinence.
Use in a report
Identify whether evidence concerns withdrawal severity, completion of a taper, or remaining benzodiazepine-free months later. This review supports outcome-specific discussion of possible adjuncts. It cannot retrospectively establish that an individual withdrawal complication would have been prevented by adding an antiseizure drug.
Source paper
Original analysis of the supplied journal article, identified as PMC13229532.
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