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withdrawal benzodiazepines

Víviam Vargas Barros, Emérita Sátiro Opaleye, Marcelo Demarzo, Sarah Bowen, Daniela Fernández Curado, Helena Hachul, Ana Regina Noto
INTRODUCTION: Dispositional mindfulness can be described as the mental ability to pay attention to the present moment, non-judgmentally. There is evidence of inverse relation between dispositional mindfulness and insomnia and substance use, but as of yet, no studies evaluating the specific association between dispositional mindfulness and the components of hypnotic use disorder. OBJECTIVE: To evaluate the association between dispositional mindfulness and the components of dependence among female chronic hypnotic users...
2018: PloS One
Lone Baandrup, Bjørn H Ebdrup, Jesper Ø Rasmussen, Jane Lindschou, Christian Gluud, Birte Y Glenthøj
BACKGROUND: Prolonged treatment with benzodiazepines is common practice despite clinical recommendations of short-term use. Benzodiazepines are used by approximately 4% of the general population, with increased prevalence in psychiatric populations and the elderly. After long-term use it is often difficult to discontinue benzodiazepines due to psychological and physiological dependence. This review investigated if pharmacological interventions can facilitate benzodiazepine tapering. OBJECTIVES: To assess the benefits and harms of pharmacological interventions to facilitate discontinuation of chronic benzodiazepine use...
March 15, 2018: Cochrane Database of Systematic Reviews
Cristiana Garisto, Zaccaria Ricci, Lorenzo Tofani, Simona Benegni, Chiara Pezzella, Paola Cogo
BACKGROUND: Dexmedetomidine is a selective agonist of α2 receptors that induces hypnotic, sedative and mild analgesic effect. The aim of our study was to test the effects of dexmedetomidine in combination with opioids and benzodiazepines compared to benzodiazepine-opioids alone. METHODS: A randomized controlled trial was conducted. Patients (children >30 days and <24 months undergoing correction of complex congenital heart diseases -CHD-) were randomized to receive 0...
March 7, 2018: Minerva Anestesiologica
Yoonsun Mo, Michael C Thomas, Corey S Laskey, Natalia Shcherbakova, Megan L Bankert, Robert H Halloran
Objective: The aim of this study was to examine current practice patterns surrounding the management of alcohol withdrawal syndrome (AWS) in the Northeast region of the United States. Methods: A survey questionnaire with several treatment options related to current practice in the management of AWS was developed. All hospitals with 100 beds or more located in the Northeast region were selected, and 512 surveys were mailed to pharmacy directors of those hospitals...
March 2018: P & T: a Peer-reviewed Journal for Formulary Management
Joelle Thorpe, Bonnie Shum, R Andrew Moore, Philip J Wiffen, Ian Gilron
BACKGROUND: Fibromyalgia is a chronic widespread pain condition affecting millions of people worldwide. Current pharmacotherapies are often ineffective and poorly tolerated. Combining different agents could provide superior pain relief and possibly also fewer side effects. OBJECTIVES: To assess the efficacy, safety, and tolerability of combination pharmacotherapy compared to monotherapy or placebo, or both, for the treatment of fibromyalgia pain in adults. SEARCH METHODS: We searched CENTRAL, MEDLINE, and Embase to September 2017...
February 19, 2018: Cochrane Database of Systematic Reviews
Ashley Jahn, Charlie Bodreau, Kate Farthing, Fawzy Elbarbry
BACKGROUND AND OBJECTIVES: While some case reports indicate that high doses of propylene glycol (PG) may result in metabolic acidosis, there has been no large-scale study that evaluated the risk of metabolic acidosis in patients receiving PG-containing benzodiazepines for acute alcohol withdrawal. This study was undertaken to evaluate the potential toxicity of PG in patients with acute alcohol withdrawal treated with intermittent intravenous bolus doses of diazepam and/or lorazepam. METHODS: This is a retrospective case study using data collected from 18 randomly selected patients receiving one or both of these medications per a modified Clinical Institute Withdrawal Assessment for Alcohol (CIWA) Class 3 protocol...
February 1, 2018: European Journal of Drug Metabolism and Pharmacokinetics
Josefina Aguiluz, Matías Álvarez, Eduardo Pimentel, Carolina Abarca, Philippa Moore
Benzodiazepines are widely used in primary health care, and their prolonged use is an important problem given the medical consequences particularly in older adults, such as dependence, cognitive impairment, and risk of falls, among others. Primary care doctors generally have few tools to help with managing withdrawal from benzodiazepines. We conducted a review of the best available evidence on practical strategies to avoid dependence at the time of the initial prescription, and to help the patient with prolonged and probably dependent use...
January 30, 2018: Medwave
Clara Oliveras, Adriana Fortea, Laura Espinosa, Pablo Barrio, Anna Lligoña, Mercè Balcells-Olivero
Las benzodiacepinas se usan para tratar la abstinencia alcohólica siguiendo varias estrategias: dosis descendiente, dosis de carga, tratamiento en función de sintomatología. La carga de diazepam ha demostrado ser un tratamiento válido para la abstinencia alcohólica en ensayos controlados aleatorizados. Tras una búsqueda bibliográfica no sistemática, no hemos encontrado antecedentes en la literatura de una estrategia de carga de diazepam sin posterior administración de benzodiacepinas para el tratamiento de la abstinencia a éstas...
January 15, 2018: Adicciones
Kaylee Caniff, Emily Telega, Jolene R Bostwick, Kristen N Gardner
PURPOSE: The available evidence for the use of pregabalin as adjunctive therapy in the discontinuation of benzodiazepines is reviewed. SUMMARY: Pregabalin has been studied as an adjunctive pharmacologic treatment for the discontinuation of long-term benzodiazepine use. Unlike carbamazepine, pregabalin has little potential for drug interactions, and its adverse effects are mostly mild and transient. Pregabalin reduces the release of excitatory neurotransmitters by binding to regulatory subunits of voltage-activated calcium channels...
January 15, 2018: American Journal of Health-system Pharmacy: AJHP
Shivanand Kattimani, Balaji Bharadwaj, Anand Babu Arun
Alcohol addiction is a chronic relapsing syndrome. Benzodiazepines remain as the mainstay for detoxification, taking care of the acute withdrawal syndrome. There is fear of dependence and abuse of benzodiazepines on prolonged use. Here, we selectively interviewed ten cases who were on longer duration of benzodiazepines to elicit their potential perceived benefits, attitudes, and any adverse effect. Three patients experienced adverse effects. None of them had features of benzodiazepine dependence. We opine that in select cases, benzodiazepine use should persist beyond detox period, and its benefits continue beyond the acute withdrawal phase while monitoring their safety/adverse effects...
April 2017: Journal of Family Medicine and Primary Care
Astrid S Haenecour, Winnie Seto, Charline M Urbain, Derek Stephens, Peter C Laussen, Corrine R Balit
OBJECTIVE: To characterise the incidence, symptoms and risk factors for withdrawal associated with prolonged dexmedetomidine infusion in paediatric critically ill patients. METHODS: Retrospective chart review in the paediatric intensive care unit and the cardiac critical care unit of a single tertiary children's hospital. Patients up to 18 years old, who received dexmedetomidine for longer than 48 hours were included. RESULTS: A total of 52 patients accounted for 68 unique dexmedetomidine treatment courses of more than 48 hours...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Toshiya Inada
Akathisia consists of subjective inner restlessness, such as awareness of the inability to remain seated, restless legs, fidgetiness, and the desire to move constantly, and of objective increased motor phenomena, such as body rocking, shifting from foot to foot, stamping in place, crossing and uncrossing legs, pacing around. Although the broad definition of akathisia includes the inner and motor restlessness observed in patients with idiopathic Parkinson's disease, post-encephalitic parkinsonism, and restless legs syndrome, here we exclusively focus on the narrow definition of antipsychotic-induced akathisia...
December 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
Leila M Soravia, Alexander Wopfner, Luzius Pfiffner, Sophie Bétrisey, Franz Moggi
Aims: As there are only a few existing experimental studies on symptom-triggered therapy for patients with alcohol withdrawal, we investigated the effectiveness of symptom-triggered detoxification regarding the use and dosage of benzodiazepine and withdrawal complications in a naturalistic clinical setting of a specialized treatment center for alcohol use disorder. Methods: In total, 301 charts of patients who entered residential treatment for alcohol withdrawal were included in the retrospective analysis...
January 1, 2018: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
Drayton A Hammond, Jordan M Rowe, Adrian Wong, Tessa L Wiley, Kristen C Lee, Sandra L Kane-Gill
Purpose: Benzodiazepines are the drug of choice for alcohol withdrawal syndrome (AWS); however, phenobarbital is an alternative agent used with or without concomitant benzodiazepine therapy. In this systematic review, we evaluate patient outcomes with phenobarbital for AWS. Methods: Medline, Cochrane Library, and Scopus were searched from 1950 through February 2017 for controlled trials and observational studies using ["phenobarbital" or "barbiturate"] and ["alcohol withdrawal" or "delirium tremens...
October 2017: Hospital Pharmacy
Niels August Willer Strand, Tonny Studsgaard Petersen, Lars Martin Nielsen, Soren Boegevig
Gamma-hydroxybutyrate (GHB) is a drug of abuse, for which physical addiction develops quickly. GHB withdrawal can develop into a life-threatening condition and has previously been treated mainly with benzodiazepines. These have not always proven effective, leading to long hospitalizations in intensive care units. Based on successful Dutch treatment results for using GHB to treat GHB withdrawal symptoms, we propose to implement a similar method in Denmark. The method requires an interdisciplinary effort for which The Danish Poison Information Centre should be consulted for expertise...
December 11, 2017: Ugeskrift for Laeger
Simon F Crowe, Elizabeth K Stranks
Objective: This study presents an updated meta-analysis of the effects of benzodiazepines on cognitive functioning in long-term, current users of these agents, those who have recently withdrawn and on those who have successfully abstained following withdrawal. The study represents an update of the previous meta-analyses published by our group. Method: A comprehensive search of the computerized databases Medline and PsycINFO was undertaken to identify studies that assessed the cognitive effects of benzodiazepines published up to 28 November 2016 (the date of the last update)...
December 13, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
Niraj R Chavan, Kristin B Ashford, Amanda T Wiggins, Michelle R Lofwall, Agatha S Critchfield
Objective  To examine the relationship between antepartum buprenorphine dose for medication-assisted treatment (MAT) of opioid use disorder (OUD) and incident neonatal opioid withdrawal syndrome (NOWS). Study Design  We performed a prospective cohort study of pregnant women with a singleton gestation diagnosed with OUD and receiving buprenorphine for MAT at a tertiary care academic institution from July 2015 to January 2017. We divided the study cohort into two groups-pregnancies with versus without NOWS...
October 2017: American Journal of Perinatology Reports
Laura Martinez, Florence Vorspan, Xavier Declèves, Julien Azuar, Maeva Fortias, Franck Questel, Alexandra Dereux, Leslie Grichy, Hélène Barreteau, Frank Bellivier, Jean-Pierre Lépine, Vanessa Bloch
High-dose baclofen is prescribed as a maintenance treatment to reduce alcohol use in patients with alcohol use disorder. Nevertheless, some patients still have massive alcohol intakes and require inpatient alcohol withdrawal. To compare the oral dose of benzodiazepine prescribed to manage alcohol withdrawal symptoms in patients with vs. without steady-state pretreatment with high-dose baclofen. Retrospective chart review study. Prescribed benzodiazepine dose expressed in diazepam-equivalent was compared between groups...
December 10, 2017: Fundamental & Clinical Pharmacology
Carmen Mannucci, Simona Pichini, Elvira Ventura Spagnolo, Fabrizio Calapai, Sebastiano Gangemi, Michele Navarra, Gioacchino Calapai
BACKGROUND: Gamma-hydroxybutyrate (GHB or sodium oxybate) is both an exogenous and endogenous molecule with neuromodulator properties. In the United States, GHB is an approved drug for the treatment of narcolepsy and narcolepsy with cataplexy in adults. In some European Union countries, sodium oxybate is applied for the treatment of opioid and alcohol withdrawal. OBJECTIVE: The aim of the present review was to describe the state of art of the pre-clinical research and the clinical evidence related to GHB used alone or in combination with other treatments in alcohol withdrawal syndrome and alcohol abstinence maintenance...
December 7, 2017: Current Drug Metabolism
Sourav Das, Divyashree Sah, Shiladitya Nandi, Payel Das
Opioid withdrawal is very rarely characterized by delirium unlike alcohol or benzodiazepine withdrawal. PubMed search through October 2016 reveals only two case series on delirium as feature of withdrawal in opioid dependence syndrome. We report two cases of opioid withdrawal (heroin) presenting with delirium when low-dose buprenorphine (2 mg/day) was added. Both the cases had no other substance abuse history and nil contributory past and family history. Both of them were improved after increasing the buprenorphine dosage to 6-8 mg/day...
September 2017: Indian Journal of Psychological Medicine
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