A successful case of dose reduction in etizolam dependence using fine granules: a case report

Shigeki Nishii,¹ Hikaru Hori,¹ Toshifumi Kishimoto,² Jun Nakamura<sup>1

1</sup>Department of Psychiatry, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan; ²Department of Psychiatry, Nara Medical University, Shijocho, Kashihara, Nara, Japan

Abstract: The prevalence of benzodiazepine consumption in Japan is one of the highest worldwide. Etizolam is the most abused drug of the benzodiazepine class. The treatment of benzodiazepine dependence is difficult. We report a case of successful dosage reduction in a 24-year-old female patient with etizolam dependence. She was diagnosed with etizolam dependence at the age of 22 years old. We proposed a benzodiazepine dependence treatment that involved replacing etizolam with a long-acting benzodiazepine class drug in conjunction with a long-term weaning plan. However, the patient refused the treatment and insisted that reducing the number of tablets would increase her anxiety. After providing a detailed explanation and receiving consent from the patient, a treatment regimen consisting of fine granules of etizolam mixed with lactose granules was begun with the aim of reducing the percentage of etizolam at a rate of 0.3 mg/week. The treatment of etizolam dependence in this patient was successful. This treatment strategy may be an effective option for patients who are difficult to treat with conventional methods, or who have anxiety regarding the reduction of the amount of the drug itself.

Keywords: benzodiazepine, Japan, dependence, etizolam