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https://www.readbyqxmd.com/read/27923198/detoxification-with-titration-and-tapering-in-gamma-hydroxybutyrate-ghb-dependent-patients-the-dutch-ghb-monitor-project
#1
Boukje A G Dijkstra, Rama Kamal, Martijn S van Noorden, Hein de Haan, Anton J M Loonen, Cor A J De Jong
BACKGROUND AND AIMS: Gamma-hydroxybutyrate (GHB) detoxification procedures have been insufficiently studied for effectiveness and safety. Based on case reports, benzodiazepines are generally regarded as first-choice agents in GHB detoxification. Detoxification by titration and tapering (DeTiTap) with pharmaceutical GHB in an open-label consecutive case series of 23 GHB-dependent patients showed to be feasible, effective and safe. This study further explored the feasibility, effectiveness and safety of this detoxification procedure in a large group of patients...
November 21, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27865151/effects-of-the-benzodiazepine-gabaa-%C3%AE-1-preferring-antagonist-3-isopropoxy-%C3%AE-carboline-hydrochloride-3-isopbc-on-alcohol-seeking-and-self-administration-in-baboons
#2
August F Holtyn, V V N Phani Babu Tiruveedhula, Michael Rajesh Stephen, James M Cook, Elise M Weerts
BACKGROUND: The major inhibitory neurotransmitter, gamma-aminobutyric acid (GABA), modulates many of the behavioral effects of alcohol, including sedation, tolerance, and withdrawal. The α1 subunit of the benzodiazepine GABAA receptor is the most widely expressed alpha subunit in the brain, and has been implicated in the reinforcing- and abuse-related effects of alcohol. The aim of the present study was to examine whether treatment with a benzodiazepine GABAA α1-preferring ligand, 3-isopropoxy-β-carboline hydrochloride (3-ISOPBC), selectively decreases alcohol seeking and consumption...
November 4, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27850872/1236-benzodiazepine-reduction-with-the-use-of-adjunct-agents-for-the-treatment-of-alcohol-withdrawal
#3
Cassandra Doyno, Stefanie Baker
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850144/504-phenobarbital-versus-benzodiazepines-in-the-treatment-of-alcohol-withdrawal-syndrome
#4
Douglas Hsu, John Marshall, George Abdallah, Randy Hollins, Peter Clardy, Michael Donnino, Kenneth Mukamal
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27848217/pregabalin-for-the-treatment-of-drug-and-alcohol-withdrawal-symptoms-a-comprehensive-review
#5
REVIEW
Rainer Freynhagen, Miroslav Backonja, Stephan Schug, Gavin Lyndon, Bruce Parsons, Stephen Watt, Regina Behar
Treatments for physical dependence and associated withdrawal symptoms following the abrupt discontinuation of prescription drugs (such as opioids and benzodiazepines), nicotine, alcohol, and cannabinoids are available, but there is still a need for new and more effective therapies. This review examines evidence supporting the potential use of pregabalin, an α2δ voltage-gated calcium channel subunit ligand, for the treatment of physical dependence and associated withdrawal symptoms. A literature search of the MEDLINE and Cochrane Library databases up to and including 11 December 2015 was conducted...
November 16, 2016: CNS Drugs
https://www.readbyqxmd.com/read/27818367/varied-responses-to-benzodiazepine-treatment-in-cephalosporin-related-generalized-periodic-discharges
#6
Hung-Yu Liu, Chien-Chen Chou, Der-Jen Yen, Hsiang-Yu Yu
Although benzodiazepines (BZDs) are used as the first-line treatment for status epilepticus, previous studies have shown inconsistent responses to BZDs in patients with cephalosporin-related non-convulsive status epilepticus. In this study, we investigated nine patients with cephalosporin-related impaired consciousness and their EEGs all showed generalized periodic discharges (GPDs). One of the patients received repetitive BZD injections without discontinuing cephalosporins, and neither his clinical symptoms nor GPDs on EEG responded to BZDs...
November 4, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/27803505/outcomes-after-implementation-of-an-alcohol-withdrawal-protocol-at-a-single-institution
#7
Mary E Eberly, Anna G Lockwood, Sean Lockwood, Kelly W Davis
Background: There are varying dosing strategies for the administration of benzodiazepines in the setting of alcohol withdrawal. In October 2014, a symptom-based alcohol withdrawal protocol (AWP) using the Clinical Institute Withdrawal Assessment of Alcohol, Revised (CIWA-Ar) scale was implemented at one institution. Objective: To evaluate the safety and efficacy of the AWP. Methods: Retrospective chart review was completed, including patients receiving at least one dose of diazepam for alcohol withdrawal pre- and post-protocol...
October 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27797817/self-disembowelment-during-delirium-tremens-why-early-diagnosis-is-vital
#8
Rachel Thomasson, Vanessa Craig, Elspeth Guthrie
Delirium tremens is a serious yet treatable complication of alcohol withdrawal. Timely diagnosis is critical as there are well-established treatment regimens that provide symptomatic relief within hours to days. We report the case of a 34-year-old man with an undisclosed history of alcohol dependency. He presented with paranoid beliefs and was transferred to a psychiatric inpatient unit with suspected schizophrenia. Classic features of delirium tremens such as sympathetic overdrive and visual hallucinations were not salient features of his presentation...
October 24, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27741141/a-subtle-mimicker-in-emergency-department-illustrated-case-reports-of-acute-drug-induced-dystonia
#9
Maria Vittoria De Angelis, Roberta Di Giacomo, Antonio Di Muzio, Marco Onofrj, Laura Bonanni
BACKGROUND: Movement disorder emergencies include any movement disorder which develops over hours to days, in which failure to appropriately diagnose and manage can result in patient morbidity or mortality.Movement disorder emergencies include acute dystonia: sustained or intermittent muscle contractions causing abnormal, often repetitive, movements. Acute dystonia is a serious challenge for emergency room doctors and neurologists, because of the high probability of misdiagnosis, due to the presence of several mimickers including partial seizures, meningitis, localized tetanus, serum electrolyte level abnormalities, strychnine poisoning, angioedema, malingering, catatonia, and conversion...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27737649/circadian-rest-activity-rhythms-during-benzodiazepine-tapering-covered-by-melatonin-versus-placebo-add-on-data-derived-from-a-randomized-clinical-trial
#10
Lone Baandrup, Ole Bernt Fasmer, Birte Yding Glenthøj, Poul Jørgen Jennum
BACKGROUND: Patients with severe mental illness often suffer from disruptions in circadian rest-activity cycles, which might partly be attributed to ongoing psychopharmacological medication. Benzodiazepines are frequently prescribed for prolonged periods despite recommendations of only short-term usage. Melatonin, a naturally occurring nocturnal hormone, has the potential to stabilize disrupted circadian rhythmicity. Our aim was to investigate how prolonged-release melatonin affects rest-activity patterns in medicated patients with severe mental illness and if benzodiazepine dose reduction is associated with changes in circadian rhythm parameters...
October 13, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27733668/evaluation-of-a-symptom-triggered-benzodiazepine-protocol-utilizing-sas-and-ciwa-ar-scoring-for-the-treatment-of-alcohol-withdrawal-syndrome-in-the-critically-ill
#11
Soumitra Sen, Philip Grgurich, Amanda Tulolo, Andrew Smith-Freedman, Yuxiu Lei, Anthony Gray, James Dargin
BACKGROUND: There are limited data on the efficacy of symptom-triggered therapy for alcohol withdrawal syndrome (AWS) in the intensive care unit (ICU). OBJECTIVE: To evaluate the safety and efficacy of a symptom-triggered benzodiazepine protocol utilizing Riker Sedation Agitation Scale (SAS) scoring for the treatment of AWS in the ICU. METHODS: We performed a before-and-after study in a medical ICU. A protocol incorporating SAS scoring and symptom-triggered benzodiazepine dosing was implemented in place of a protocol that utilized the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale and fixed benzodiazepine dosing...
October 12, 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27687167/psychiatric-emergencies-for-clinicians-emergency-department-management-of-benzodiazepine-withdrawal
#12
Sara E Puening, Michael P Wilson, Kimberly Nordstrom
No abstract text is available yet for this article.
September 26, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27677382/improving-ghb-withdrawal-with-baclofen-study-protocol-for-a-feasibility-study-for-a-randomised-controlled-trial
#13
Anne Lingford-Hughes, Yash Patel, Owen Bowden-Jones, Mike J Crawford, Paul I Dargan, Fabiana Gordon, Steve Parrott, Tim Weaver, David M Wood
BACKGROUND: GHB (gamma-hydroxybutyrate) and its pro-drugs GBL (gamma-butyrolactone) and 1,4-butanediol (1,4-BD) are central nervous system depressants whose street names include 'G' and 'liquid ecstasy'. They are used recreationally predominately for their stimulant and pro-sexual effects or for sedation to help with sleep and/or to 'come down' after using stimulant recreational drugs. Although overall population prevalence is low (0.1 %), in some groups such as men who have sex with men, GHB/GBL use may reach 20 %...
September 27, 2016: Trials
https://www.readbyqxmd.com/read/27549604/benzodiazepine-misuse-in-the-elderly-risk-factors-consequences-and-management
#14
REVIEW
Guillaume Airagnes, Antoine Pelissolo, Mélanie Lavallée, Martine Flament, Frédéric Limosin
Benzodiazepine (BZD) inappropriate use (i.e., misuse and overuse) is a worldwide public health problem. Despite current knowledge about increased sensitivity to side effects in the elderly, that should lead to more caution, only a third of BZD prescriptions in this age group are considered appropriate. The most frequent inadequate situations are excessive duration and/or dosage of a medical prescription or self-medication, especially in a context where it would be contraindicated, e.g., long-acting BZD in the elderly...
October 2016: Current Psychiatry Reports
https://www.readbyqxmd.com/read/27547472/takotsubo-cardiomyopathy-and-catatonia-in-the-setting-of-benzodiazepine-withdrawal
#15
Teng J Peng, Nicholas D Patchett, Sheilah A Bernard
We report two serious and unusual complications of benzodiazepine withdrawal in a single patient: takotsubo cardiomyopathy and catatonia. This 61-year-old female patient was brought to the emergency department with lethargy and within hours had declined into a state of catatonia. Although there was never a complaint of chest pain, ECG showed deep anterior T-wave inversions and cardiac enzymes were elevated. An echocardiogram was consistent with takotsubo cardiomyopathy. She later received 1 mg of midazolam and within minutes had resolution of catatonic symptoms...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27490534/the-impact-of-anti-epileptic-drugs-on-growth-and-bone-metabolism
#16
REVIEW
Hueng-Chuen Fan, Herng-Shen Lee, Kai-Ping Chang, Yi-Yen Lee, Hsin-Chuan Lai, Pi-Lien Hung, Hsiu-Fen Lee, Ching-Shiang Chi
Epilepsy is a common neurological disorder worldwide and anti-epileptic drugs (AEDs) are always the first choice for treatment. However, more than 50% of patients with epilepsy who take AEDs have reported bone abnormalities. Cytochrome P450 (CYP450) isoenzymes are induced by AEDs, especially the classical AEDs, such as benzodiazepines (BZDs), carbamazepine (CBZ), phenytoin (PT), phenobarbital (PB), and valproic acid (VPA). The induction of CYP450 isoenzymes may cause vitamin D deficiency, hypocalcemia, increased fracture risks, and altered bone turnover, leading to impaired bone mineral density (BMD)...
August 1, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27471419/novel-class-of-medications-orexin-receptor-antagonists-in-the-treatment-of-insomnia-critical-appraisal-of-suvorexant
#17
REVIEW
Jessica L Norman, Sarah L Anderson
Insomnia, a highly prevalent disorder, can be detrimental to patients' overall health and worsen existing comorbidities. Patients may have acute episodes of insomnia related to a traumatic event, but more commonly insomnia occurs chronically. While proper sleep hygiene and behavioral therapy play important roles in the nonpharmacologic management of short-term and chronic insomnia, medications may also be required. Historically, insomnia has been treated with agents such as benzodiazepines, nonbenzodiazepine receptor agonists, and melatonin agonists...
2016: Nature and Science of Sleep
https://www.readbyqxmd.com/read/27454068/analgesia-and-sedation-protocol-for-mechanically-ventilated-postsurgical-children-reduces-benzodiazepines-and-withdrawal-symptoms-but-not-in-all-patients
#18
Felix Neunhoeffer, Guido Seitz, Andreas Schmidt, Hanna Renk, Matthias Kumpf, Frank Fideler, Martin Esslinger, Ines Gerbig, Jörg Fuchs, Michael Hofbeck
Background We demonstrated recently that the implementation of a nurse-driven analgesia and sedation protocol (pediatric analgesia and sedation protocol [pASP]) for mechanically ventilated nonpostsurgical patients reduces the total dose of benzodiazepines and the withdrawal symptoms significantly. It has not been investigated if these results can also be expected in the group of patients undergoing surgery. Objectives To evaluate the effects of the pASP in mechanically ventilated postsurgical children regarding drug dosage, duration of mechanical ventilation, length of stay, and rate of withdrawal symptoms...
July 25, 2016: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27451330/deprescribing-in-older-people
#19
REVIEW
Amy Theresa Page, Kathleen Potter, Rhonda Clifford, Christopher Etherton-Beer
Older people with chronic disease have great potential to benefit from their medications but are also at high risk of harm from their medications. The use of medications is particularly important for symptom control and disease progression in older people. Under-treatment means older people can miss out on the potential benefits of useful medications, while over-treatment (polypharmacy) puts them at increased risk of harm. Deprescribing attempts to balance the potential for benefit and harm by systematically withdrawing inappropriate medications with the goal of managing polypharmacy and improving outcomes...
September 2016: Maturitas
https://www.readbyqxmd.com/read/27448254/perceived-stress-related-to-methadone-withdrawal
#20
Amparo Carreras Alabau, José A Carrobles Isabel, Carmen Almendros Rodríguez
BACKGROUND: Stress is a known risk factor in addiction relapse, and prior studies show that relapse induced by stress may be more likely than drug-cue induced relapse. The main goal of our research was to establish the influence of perceived stress in methadone withdrawal outcome and the psychological factors involved. METHOD: A sample of 81 methadone maintenance treatment outpatients was evaluated and then observed during methadone dose reduction. RESULTS: a multivariate analysis first showed that successful detoxification was predicted by perceived stress, patient-clinic staff agreement, pharmacotherapy support and social care; and second, perceived stress was predicted by anxiety, depression, self-control, social care and benzodiazepine use...
August 2016: Psicothema
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