0408 A Blinded Hypnotic Tapering Approach for Hypnotic discontinuation
Bibliographic record
Abstract
Hypnotic users commonly make unsuccessful attempts to discontinue their hypnotics. This study tested a blinded tapering approach to reduce anxiety and help patients discontinue their hypnotics. This study enrolled 78 (M age = 55.2 ± 12.8 yrs.; 65.4% women) users of benzodiazepine and benzodiazepine receptor agonists. Enrollees completed baseline measures including the Insomnia Severity Index (ISI). They then completed 4 sessions of cognitive behavioral insomnia therapy (CBTI). Subsequently they were randomized to one of three 20-week, double-blinded tapering protocols wherein their medication dosage was either reduced by 25% or 10% every two weeks, or remained unchanged (CTRL). During tapering, all enrollees were seen biweekly by the study physician for support and guidance. At the end of the 20-week period the study blind was eliminated and those who completed one of the two blinded tapering protocols entered a 3-month follow-up period, whereas CTRL participants are offered an open label taper before completing the follow-up. Baseline ISI scores (ISI=18.07±0.58) showed that the total sample entered the trial with moderately severe insomnia complaints despite almost nightly hypnotic use. These scores declined into the mild range after CBTI (10.19±0.53) and tapering (9.62±.63) and approached the normative range by follow-up (7.59±1.05). Of the 45 who completed one of the blinded tapering protocols to date, 39 (86.7%) totally discontinued their medication use by the end of the 20-week tapering phase whereas 12 (75%) of 16 in the CTRL group discontinued hypnotic use by the end of their open label tapering. At follow-up 22 of 30 (73.3%) who completed blinded tapering remained medication free whereas only 5 of 14 (35.7%) in the CTRL group who underwent open-label tapering remained medication free. CBTI combined with blinded hypnotic tapering seems a promising treatment approach to help hypnotic users overcome their medication dependence and improve insomnia symptoms. National Institute of Drug Abuse, Grant # R34 DA042329-01
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".