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withdrawal benzodiazepines

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https://www.readbyqxmd.com/read/29164160/use-of-phenobarbital-in-delirium-tremens
#1
Jeffrey Fujimoto, Jerry J Lou, Antonio M Pessegueiro
The standard of care for alcohol withdrawal centers on the use of escalating doses of benzodiazepines until clinical improvement is achieved. However, there is no established standard in the care of patients with severe alcohol withdrawal and delirium tremens that is refractory to benzodiazepine therapy. One potential therapy that is gaining traction is the use of phenobarbital, which may be mechanistically superior to benzodiazepines in treating delirium tremens because of its effects on GABA and N-methyl-D-aspartate receptors...
October 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29048739/pharmacotherapy-for-social-anxiety-disorder-sand
#2
REVIEW
Taryn Williams, Coenraad J Hattingh, Catherine M Kariuki, Sean A Tromp, Anton J van Balkom, Jonathan C Ipser, Dan J Stein
BACKGROUND: Recognition is growing that social anxiety disorder (SAnD) is a chronic and disabling disorder, and data from early trials demonstrate that medication may be effective in its treatment. This systematic review is an update of an earlier review of pharmacotherapy of SAnD. OBJECTIVES: To assess the effects of pharmacotherapy for social anxiety disorder in adults and identify which factors (methodological or clinical) predict response to treatment. SEARCH METHODS: We searched the Cochrane Common Mental Disorders Controlled Trials Register (CCMDCTR-Studies and CCMDCTR-References) to 17 August 2015...
October 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29037335/-catatonia-and-delirium-syndromes-that-may-converge-in-the-neuropsychiatric-patient
#3
Andrés Felipe Pérez-González, Mariana Espinola-Nadurille, Jesús Ramírez-Bermúdez
INTRODUCTION: Catatonia and delirium are two different and independent syndromes. Catatonia is a psychomotor syndrome associated with a variety of diseases of different medical causes and is characterised by lack of activity, induction of passive postures against gravity, opposition or absence of response to external stimuli, waxy flexibility, stereotypies, mannerisms and echophenomena. Delirium is characterised by consciousness and cognitive alterations, mainly attention and orientation and usually of acute onset, which tend to fluctuate during the day and with evidence that the alteration is a direct physiological consequence of a disease, intoxication or substance withdrawal...
October 2017: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/28994603/suvorexant-scientifically-interesting-utility-uncertain
#4
Nicholas A Keks, Judy Hope, Simone Keogh
OBJECTIVE: Suvorexant, a new hypnotic, is indicated for the treatment of insomnia characterized by difficulties with sleep onset and/or sleep maintenance, and is used long-term. This paper will briefly review suvorexant. RESULTS: Orexin is a hypothalamic peptide which promotes wakefulness. By blocking orexin receptors, suvorexant induces sleep. Peaking 2 h after ingestion, it has a half-life of 12 h and is hepatically metabolized mainly by CYP3A. Kinetics are not affected by age but concentrations are higher in females and obese patients...
October 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28981333/evaluation-of-the-appropriate-use-of-a-ciwa-ar-alcohol-withdrawal-protocol-in-the-general-hospital-setting
#5
Amanda S Eloma, Jason M Tucciarone, Edmund M Hayes, Brian D Bronson
BACKGROUND: The Clinical Institute Withdrawal Assessment-Alcohol, Revised (CIWA-Ar) is an assessment tool used to quantify alcohol withdrawal syndrome (AWS) severity and inform benzodiazepine treatment for alcohol withdrawal. OBJECTIVES: To evaluate the prescribing patterns and appropriate use of the CIWA-Ar protocol in a general hospital setting, as determined by the presence or absence of documented AWS risk factors, patients' ability to communicate, and provider awareness of the CIWA-Ar order...
October 5, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28965464/recurrent-benzodiazepine-withdrawal-catatonia-in-an-older-adult
#6
Lindsay G Lebin, Joseph M Cerimele
No abstract text is available yet for this article.
October 1, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28958437/a-thorough-qt-qtc-study-of-clobazam-in-healthy-volunteers
#7
Dwain Tolbert, Judy Gordon, Stuart Harris, Mark Walzer, Ihor Bekersky, Susan Reid
PURPOSE: A thorough QT study was conducted to assess the proarrhythmic potential of clobazam and its active metabolite, N-desmethylclobazam (N-CLB). METHODS: In this Phase I, single-site, randomized, double-blind, double-dummy, parallel-group study, healthy participants were randomized to 1 of 4 treatment groups: clobazam 40 mg/d (maximum therapeutic dosage), clobazam 160 mg/d (supratherapeutic dosage), placebo, or moxifloxacin 400 mg (active control). FINDINGS: Of 280 enrolled participants (n = 70 per treatment arm), 250 (92%) completed the study; 194 were included in the pharmacokinetics population (clobazam 40 mg/d, n = 66; clobazam 160 mg/d, n = 62; and moxifloxacin, n = 66)...
September 25, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28953788/benzodiazepines-in-combination-with-antipsychotic-drugs-for-schizophrenia-gaba-ergic-targeted-therapy
#8
Adam Włodarczyk, Joanna Szarmach, Wiesław Jerzy Cubała, Mariusz Stanisław Wiglusz
Antipsychotics are a key intervention strategy in pharmacotherapy of schizophrenia. However, benzodiazepines are often prescribed to control sleep disturbances, anxiety or behavioural disinhibition. There is clinical evidence for the beneficial effect of the combined treatment of antipsychotics and benzodiazepines resulting in more favorable treatment outcome in schizophrenia with regard to positive and negative symptoms. This clinical phenomenon seems to be associated with the GABA-ergic activit ythat is believed to be disrupted in the schizophrenia and direct benzodiazepines effect on GABA-A receptors...
September 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28940626/using-the-sophia-observational-withdrawal-scale-improved-the-assessment-of-paediatric-iatrogenic-withdrawal-symptoms
#9
Bettina N Nielsen, Ulrikka Nygaard, Lise Hvidt, Kaare Lundstrøm
No abstract text is available yet for this article.
September 22, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28936791/nmda-receptors-and-no-cgmp-signaling-pathway-mediate-the-diazepam-induced-sensitization-to-withdrawal-signs-in-mice
#10
Sylwia Talarek, Joanna Listos, Jolanta Orzelska-Gorka, Anna Serefko, Jolanta Kotlińska
The goal of the present study was to examine the effects of N-methyl-aspartate (NMDA) receptor antagonists-memantine and ketamine and the drugs modifying the NO:cGMP pathway-NG-nitro-L-arginine methyl ester (L-NAME) and 7-nitroindazole (7-NI), the endogenous precursor of NO-L-arginine, and the guanylyl cyclase inhibitor-methylene blue (MB) on the development of sensitization to withdrawal signs precipitated after chronic, interrupted treatment with diazepam, a benzodiazepine receptor agonist, in mice. To develop the sensitization, the mice were divided into groups: continuously and sporadically (with two diazepam-free periods) treated with diazepam (15 mg/kg, sc)...
September 21, 2017: Neurotoxicity Research
https://www.readbyqxmd.com/read/28931433/role-of-gabaa-receptors-in-alcohol-use-disorders-suggested-by-chronic-intermittent-ethanol-cie-rodent-model
#11
REVIEW
Richard W Olsen, Jing Liang
GABAergic inhibitory transmission is involved in the acute and chronic effects of ethanol on the brain and behavior. One-dose ethanol exposure induces transient plastic changes in GABAA receptor subunit levels, composition, and regional and subcellular localization. Rapid down-regulation of early responder δ subunit-containing GABAA receptor subtypes mediating ethanol-sensitive tonic inhibitory currents in critical neuronal circuits corresponds to rapid tolerance to ethanol's behavioral responses. Slightly slower, α1 subunit-containing GABAA receptor subtypes mediating ethanol-insensitive synaptic inhibition are down-regulated, corresponding to tolerance to additional ethanol behaviors plus cross-tolerance to other GABAergic drugs including benzodiazepines, anesthetics, and neurosteroids, especially sedative-hypnotic effects...
September 20, 2017: Molecular Brain
https://www.readbyqxmd.com/read/28931308/clinical-factors-associated-with-adherence-to-the-premedication-protocol-for-withdrawal-of-mechanical-ventilation-in-terminally-ill-patients-a-4-year-experience-at-a-single-medical-center-in-asia
#12
Chao-Hui Wang, Pei-Wei Huang, Chia-Yen Hung, Shu-Hui Lee, Chen-Yi Kao, Hung-Ming Wang, Yu-Shin Hung, Po-Jung Su, Yung-Chia Kuo, Chia-Hsun Hsieh, Wen-Chi Chou
PURPOSE: Data on end-of-life care practices in Asia are scarce. This study aimed to analyze the clinical factors associated with the recommended premedication protocol for mechanical ventilation withdrawal, in Taiwan. METHODS: A total of 135 terminally ill patients who had mechanical ventilation withdrawn between 2013 and 2016 from a single medical center in Taiwan were enrolled. A premedication protocol of morphine and midazolam intravenous bolus was routinely recommended for the patients before mechanical ventilation withdrawal...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28917332/-benzodiazepine-withdrawal-syndrome-in-the-elderly-patient
#13
Aurélien Martin-Kleisch, Abrar-Ahmad Zulfiqar
Withdrawal syndrome is a well known diagnostic entity. As the symptomatology related to this syndrome is extremely unspecific, care must be taken not to ignore withdrawal syndrome, the consequences of which, while rare, can lead to often long and complicated hospitalisations.
September 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28891380/stories-of-hell-and-healing-internet-users-construction-of-benzodiazepine-distress-and-withdrawal
#14
Alison M Fixsen, Damien Ridge
Benzodiazepines are a group of drugs used mainly as sedatives, hypnotics, antiepileptics, and muscle relaxants. Consumption is recommended for 2 to 4 weeks only, due to fast onset of dependency and potentially distressing withdrawal symptoms. Few peer-review studies have drawn on the user experiences and language to appreciate firsthand experiences of benzodiazepine withdrawal or discontinuation syndrome. We looked extensively at patient stories of benzodiazepine withdrawal and recovery on Internet support sites and YouTube...
September 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28891099/opioid-and-benzodiazepine-weaning-in-pediatric-patients-review-of-current-literature
#15
Norman E Fenn, Kimberly S Plake
Pediatric opioid and benzodiazepine withdrawal are avoidable complications of pain and sedation management that is well described in the literature. To prevent withdrawal from occurring, practitioners regularly use a steady decrease of pain and sedation medications, also known as a weaning or tapering schedule. The weaning schedule is highly variable based on clinician preference and is usually dependent on the clinician. The purposes of this review are to evaluate the current literature on the process of opioid and benzodiazepine weaning in pediatric patients and to assess the various standardized protocols used to decrease withdrawal occurrences...
September 11, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28874253/-benzodiazepines-still-play-a-role-in-modern-psychiatric-therapy
#16
Martin Balslev Jørgensen, Poul Videbech, Merete Osler
Benzodiazepines (BZ) are widely used for anxiety across psychiatric diagnoses, but for the last decades regulation has been increasingly tight due to problems with tolerance, addiction, withdrawal symptoms and cognitive side effects. Some guidelines claim that BZ only work for a few weeks, and that BZ cause traffic accidents, increased mortality and dementia. In Denmark, the use of BZ has been substantially reduced. In this article it is argued, that not all patients habituate, that most of the epidemiological findings are hampered by confounding, and that there still is a role for long-term use of BZ in the treatment of anxiety...
September 4, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28866754/opioid-associated-iatrogenic-withdrawal-in-critically-ill-adult-patients-a-multicenter-prospective-observational-study
#17
Pan Pan Wang, Elaine Huang, Xue Feng, Charles-André Bray, Marc M Perreault, Philippe Rico, Patrick Bellemare, Paul Murgoi, Céline Gélinas, Annie Lecavalier, Dev Jayaraman, Anne Julie Frenette, David Williamson
BACKGROUND: Opioids and benzodiazepines are frequently used in the intensive care unit (ICU). Regular use and prolonged exposure to opioids in ICU patients followed by abrupt tapering or cessation may lead to iatrogenic withdrawal syndrome (IWS). IWS is well described in pediatrics, but no prospective study has evaluated this syndrome in adult ICU patients. The objective of this study was to determine the incidence of IWS caused by opioids in a critically ill adult population. This multicenter prospective cohort study was conducted at two level-1 trauma ICUs between February 2015 and September 2015 and included 54 critically ill patients...
September 2, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28812541/systematic-review-of-interventions-for-treating-or-preventing-antipsychotic-induced-tardive-dyskinesia
#18
Hanna Bergman, Dawn-Marie Walker, Adriani Nikolakopoulou, Karla Soares-Weiser, Clive E Adams
BACKGROUND: Antipsychotic medication can cause tardive dyskinesia (TD) - late-onset, involuntary, repetitive movements, often involving the face and tongue. TD occurs in > 20% of adults taking antipsychotic medication (first-generation antipsychotics for > 3 months), with this proportion increasing by 5% per year among those who continue to use these drugs. The incidence of TD among those taking newer antipsychotics is not different from the rate in people who have used older-generation drugs in moderate doses...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28795846/a-novel-non-opioid-protocol-for-medically-supervised-opioid-withdrawal-and-transition-to-antagonist-treatment
#19
Gregory Rudolf, Jim Walsh, Abigail Plawman, Paul Gianutsos, William Alto, Lloyd Mancl, Vania Rudolf
BACKGROUND: The clinical feasibility of a novel non-opioid and benzodiazepine-free protocol was assessed for the treatment of medically supervised opioid withdrawal and transition to subsequent relapse prevention strategies. METHODS: A retrospective chart review of DSM-IV diagnosed opioid-dependent patients admitted for inpatient medically supervised withdrawal examined 84 subjects (52 males, 32 females) treated with a 4-day protocol of scheduled tizanidine, hydroxyzine, and gabapentin...
August 10, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28793780/iatrogenic-opioid-withdrawal-in-critically-ill-patients-a-review-of-assessment-tools-and-management
#20
Ada W Chiu, Sofia Contreras, Sangeeta Mehta, Jennifer Korman, Marc M Perreault, David R Williamson, Lisa D Burry
OBJECTIVE: To (1) provide an overview of the epidemiology, clinical presentation, and risk factors of iatrogenic opioid withdrawal in critically ill patients and (2) conduct a literature review of assessment and management of iatrogenic opioid withdrawal in critically ill patients. DATA SOURCES: We searched MEDLINE (1946-June 2017), EMBASE (1974-June 2017), and CINAHL (1982-June 2017) with the terms opioid withdrawal, opioid, opiate, critical care, critically ill, assessment tool, scale, taper, weaning, and management...
August 1, 2017: Annals of Pharmacotherapy
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