Summary of findings 2. Carbamazepine compared with placebo for benzodiazepine discontinuation in chronic benzodiazepine users.
| Carbamazepine compared with placebo for benzodiazepine discontinuation in chronic benzodiazepine users | ||||||
| Patient or population: adults who withdraw from chronic benzodiazepine use Settings: outpatients Intervention: carbamazepine Comparison: placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Placebo | Carbamazepine | |||||
| Benzodiazepine discontinuation, end of intervention | Study population | RR 1.33 (0.99 to 1.8) | 147 (3 studies) | ⊕⊕⊝⊝ low1,2 | Trial Sequential Analysis showed that only 7.0% of the required information size (2109) was reached, indicating that insufficient information has been obtained. | |
| 480 per 1000 | 638 per 1000 (475 to 864) | |||||
| Benzodiazepine discontinuation, longest follow‐up | Study population | RR 1.41 (0.86 to 2.29) | 40 (1 study) | ⊕⊝⊝⊝ very low3,4 | ||
| 524 per 1000 | 739 per 1000 (450 to 1000) | |||||
| Benzodiazepine withdrawal symptoms, end of intervention | The mean benzodiazepine withdrawal symptoms in the intervention groups was 1.14 standard deviations lower (2.43 lower to 0.16 higher). | 76 (2 studies) | ⊕⊝⊝⊝ very low1,5,6 | SMD ‐1.14 (‐2.43 to 0.16). As a rule of thumb, 0.2 represents a small effect, 0.5 a moderate effect, and 0.8 a large effect. |
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| Benzodiazepine withdrawal symptoms, longest follow‐up | Not estimable | ‐ | (0 study) | No included study measured this outcome. | ||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio: SMD: standardised mean difference | ||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low quality: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
1Unclear risk of selection bias. One study with high risk of attrition, reporting, and other bias (downgraded one level). 2Required information size not met (downgraded one level due to imprecision). 3Unclear risk of selection and attrition bias (downgraded one level). 4Required information size not met, and 95% CI includes both no effect and appreciable benefit (downgraded two levels due to imprecision). 5Required information size not met (downgraded one level for imprecision). 6Significant heterogeneity (downgraded one level for inconsistency).