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benzodiazepines discontinuation

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https://www.readbyqxmd.com/read/28617210/antipsychotic-medication-use-among-publicly-insured-pregnant-women-in-the-united-states
#1
Yoonyoung Park, Krista F Huybrechts, Jacqueline M Cohen, Brian T Bateman, Rishi J Desai, Elisabetta Patorno, Helen Mogun, Lee S Cohen, Sonia Hernandez-Diaz
OBJECTIVE: Given the increasing use and broadening of indications for use of antipsychotic medications in the general population, as well as the paucity of information on the safety of this drug class during pregnancy, the study documented patterns of antipsychotic medication use among pregnant women. METHODS: Medicaid Analytic eXtract data (2001-2010) from pregnant women who delivered live-born infants were used. Antipsychotic use at both the class and the individual drug level was defined based on dispensed outpatient prescriptions...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28593281/simultaneous-antidepressant-and-benzodiazepine-new-use-and-subsequent-long-term-benzodiazepine-use-in-adults-with-depression-united-states-2001-2014
#2
Greta A Bushnell, Til Stürmer, Bradley N Gaynes, Virginia Pate, Matthew Miller
Importance: Benzodiazepines have been prescribed for short periods to patients with depression who are beginning antidepressant therapy to improve depressive symptoms more quickly, mitigate concomitant anxiety, and improve antidepressant treatment continuation. However, benzodiazepine therapy is associated with risks, including dependency, which may take only a few weeks to develop. Objectives: To examine trends in simultaneous benzodiazepine and antidepressant new use among adults with depression initiating an antidepressant, assess antidepressant treatment length by simultaneous new use status, estimate subsequent long-term benzodiazepine use in those with simultaneous antidepressant and benzodiazepine new use, and identify determinants of simultaneous new use and long-term benzodiazepine use...
June 7, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28570796/neonatal-discontinuation-syndrome-in-serotonergic-antidepressant-exposed-neonates
#3
MULTICENTER STUDY
Amy Yang, Jody D Ciolino, Emily Pinheiro, Laura J Rasmussen-Torvik, Dorothy K Y Sit, Katherine L Wisner
OBJECTIVE: To determine whether infants exposed in utero to serotonin reuptake inhibitor (SRI) antidepressants or a DSM-IV-TR-defined mood disorder have significantly more neonatal discontinuation signs compared to an unexposed group of infants at 2-4 weeks after birth. METHODS: This secondary analysis was derived from 2 observational studies with enrollment from July 2000 to December 2011 in Cleveland, Ohio, and Pittsburgh, Pennsylvania. Mothers (n = 214) belonged to one of 3 groups based on exposure status during pregnancy: (1) Comparison-women who did not take psychotropics during pregnancy and had no major mood disorder; (2) SRI-exposed-women with a mood disorder who were taking an SRI but no benzodiazepines; and (3) Mood Disorder-women with depression or bipolar disorder who did not take psychotropic medications...
May 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28540039/successful-withdrawal-from-high-dose-benzodiazepine-in-a-young-patient-through-electronic-monitoring-of-polypharmacy-a-case-report-in-an-ambulatory-setting
#4
REVIEW
Hèctor R Loscertales, Valerie Wentzky, Kenneth Dürsteler, Johannes Strasser, Kurt E Hersberger, Isabelle Arnet
BACKGROUND: Dependence on high-dose benzodiazepines (BZDs) is well known and discontinuation attempts are generally unsuccessful. A well established protocol for high-dose BZD withdrawal management is lacking. We present the case of withdrawal from high-dose lorazepam (>20 mg daily) in an unemployed 35-year-old male outpatient through agonist substitution with long-acting clonazepam and electronic monitoring over 28 weeks. METHODS: All medicines were repacked into weekly 7 × 4 cavity multidose punch cards with an electronic monitoring system...
May 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28495392/elderly-polypharmacy-patients-needs-and-concerns-regarding-medication-assessed-using-the-structured-patient-pharmacist-consultation-model
#5
Sandra Vezmar Kovačević, Branislava Miljković, Katarina Vučićević, Milica Ćulafić, Milena Kovačević, Bojana Golubović, Marija Jovanović, Johan J de Gier
OBJECTIVE: To evaluate elderly polypharmacy patients' needs and concerns regarding medication through the Structured Patient-Pharmacist Consultation (SPPC). METHODS: Older patients on chronic treatment with ≥5 medications were asked to fill in the SPPC form at home. A consultation with the community pharmacist, structured according to patient's answers, followed within 2-4 weeks. Logistic regression associated patients' individual treatment with care issues and consultation outcomes...
May 1, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28456823/a-systematic-review-of-interventions-to-deprescribe-benzodiazepines-and-other-hypnotics-among-older-people
#6
REVIEW
Emily Reeve, Magdalene Ong, Angela Wu, Jesse Jansen, Mirko Petrovic, Danijela Gnjidic
PURPOSE: Benzodiazepines are effective medicines for insomnia and anxiety but are commonly used beyond recommended treatment time frames, which may lead to adverse drug events. The aim of this systematic review was to critically evaluate the success of interventions used to reduce benzodiazepines and 'Z-drug' use, and the impact of these interventions on clinical outcomes in older adults. METHODS: A search was conducted in PubMed, Embase, Informit, International Pharmaceutical Abstracts, Scopus, PsychINFO, Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL...
April 30, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28422845/response-to-benzodiazepines-and-the-clinical-course-in-malignant-catatonia-associated-with-schizophrenia-a-case-report
#7
Kazutaka Ohi, Aki Kuwata, Takamitsu Shimada, Toshiki Yasuyama, Yusuke Nitta, Takashi Uehara, Yasuhiro Kawasaki
BACKGROUND: Malignant catatonia (MC) is a disorder consisting of catatonic symptoms, hyperthermia, autonomic instability, and altered mental status. Neuroleptic malignant syndrome (NMS) caused by antipsychotics is considered a variant of MC. Benzodiazepine (BZD) medications are safe and effective treatments providing rapid relief from MC. This case study reports a detailed clinical course of a case of MC associated with schizophrenia initially diagnosed as NMS that responded successfully to BZDs but not to dantrolene...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28399441/sleep-architecture-in-insomniacs-with-severe-benzodiazepine-abuse
#8
Mauro Manconi, Raffaele Ferri, Silvia Miano, Michelangelo Maestri, Valentina Bottasini, Marco Zucconi, Luigi Ferini-Strambi
OBJECTIVE: Benzodiazepines (BZDs) are the most commonly prescribed compounds in insomnia. A long-term of BZDs use may cause dependence and abuse. The aim of this study was to evaluate sleep architecture and microstructure (in terms of cyclic alternating pattern - CAP - analysis and of sleep EEG power spectral analysis) in a group of long-term users of high doses of BZDs for their primary chronic insomnia. METHODS: Twenty patients consecutively admitted at the Sleep Centre for drug discontinuation and 13 matched healthy controls underwent a full nocturnal video-polysomnographic recording, after one adaptation night...
June 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28396815/catatonia-secondary-to-sudden-clozapine-withdrawal-a-case-with-three-repeated-episodes-and-a-literature-review
#9
John Bilbily, Betsy McCollum, Jose de Leon
A literature search identified 9 previously published cases that were considered as possible cases of catatonia secondary to sudden clozapine withdrawal. Two of these 9 cases did not provide enough information to make a diagnosis of catatonia according to the Diagnostic and Statistical Manual, 5th Edition (DSM-5). The Liverpool Adverse Drug Reaction (ADR) Causality Scale was modified to assess ADRs secondary to drug withdrawal. From the 7 published cases which met DSM-5 catatonia criteria, using the modified scale, we established that 3 were definitive and 4 were probable cases of catatonia secondary to clozapine withdrawal...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28182456/the-impact-of-service-connected-disability-and-therapist-experience-on-outcomes-from-prolonged-exposure-therapy-with-veterans
#10
Jason T Goodson, Amy W Helstrom, Emily J Marino, Rachel V Smith
OBJECTIVE: Although prolonged exposure therapy (PE) has been shown to be effective in treating posttraumatic stress disorder (PTSD), a sizable minority do not benefit. Examining patient and therapist characteristics that impact treatment outcome may improve treatment delivery and identify individuals who are less likely to respond to treatment or are at risk to prematurely discontinue treatment. The current study uses a sample from a large urban Veterans' Affairs (VA) hospital to build on a previous report that identified correlates of treatment outcome for Veterans who received PE...
February 9, 2017: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/28181946/case-report-of-midazolam-withdrawal-induced-catatonia-in-a-9-year-old-patient
#11
Cassandra R Duncan-Azadi, Peter N Johnson, Andrew Gormley
Benzodiazepine withdrawal-induced catatonia is a rare phenomenon in the adult population and has never been reported in a pediatric patient. We present a 9-year-old boy who exhibited catatonia symptoms following discontinuation of a midazolam infusion in the pediatric intensive care unit. The pediatric anesthesia acute pain team was consulted. When the patient's altered mental status could not otherwise be explained, benzodiazepine withdrawal-induced catatonia was considered. A dose of 2 mg intravenous lorazepam was given and the patient's symptoms dramatically improved within 5 minutes of administration...
February 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28152179/central-nervous-system-medication-burden-and-serious-falls-in-older-nursing-home-residents
#12
Joseph T Hanlon, Xinhua Zhao, Jennifer G Naples, Sherrie L Aspinall, Subashan Perera, David A Nace, Nicholas G Castle, Susan L Greenspan, Carolyn T Thorpe
OBJECTIVES: To examine the association between CNS medication burden and serious falls in those with a recent fall history. DESIGN: Nested-case control study; cases matched to four controls by age, gender, and date. SETTING: US nursing homes. PARTICIPANTS: 5,556 residents age ≥65 with a recent fall history admitted to a nursing home between 1/1-9/30/2010 and followed until discharge, death, or December 31, 2010. MEASUREMENTS: Outcome was serious falls as per Medicare Part A and B ICD/CPT codes...
June 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28143413/use-of-the-empower-brochure-to-deprescribe-sedative-hypnotic-drugs-in-older-adults-with-mild-cognitive-impairment
#13
RANDOMIZED CONTROLLED TRIAL
Philippe Martin, Cara Tannenbaum
BACKGROUND: Evidence-based mailed educational brochures about the harms of sedative-hypnotic use lead to discontinuation of chronic benzodiazepine use in older adults. It remains unknown whether patients with mild cognitive impairment (MCI) are able to understand the information in the EMPOWER brochures, and whether they achieve similar rates of benzodiazepine discontinuation. METHODS: Post-hoc analysis of the EMPOWER randomized, double-blind, wait-list controlled trial that assessed the effect of a direct-to-consumer educational intervention on benzodiazepine discontinuation...
January 31, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28125446/inpatient-gamma-hydroxybutyrate-detoxification-a-case-report-describing-day-to-day-therapeutic-management
#14
Louis von Theobald, Morgane Rousselet, Jennyfer Cholet, Hélène Debar, David Boels, Caroline Victorri-Vigneau, Marie Grall-Bronnec
BACKGROUND: Gamma-hydroxybutyrate (GHB) is a synthetic drug increasingly used by consumers of psychoactive substances. The sought after psychoactive effects of GHB have resulted in an increase in recreational use in Europe. GHB is considered to have a high dependence potential, and abrupt discontinuation after long-term use can result in a severe withdrawal syndrome. Despite a large number of publications related to GHB withdrawal and detoxification, to date, no evidence-based protocol or consensual international therapeutic guidelines are available (over and above the administration of benzodiazepines)...
May 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28105500/-discontinuation-of-benzodiazepines-in-old-age-when-and-if-so-how
#15
Dirk K Wolter
Although viewed critically in geriatrics, benzodiazepine use is still common among old people. Before reducing the dosage the following questions must be considered: 1. Are there indications for benzodiazepine treatment and will discontinuation cause relevant rebound symptoms of the initial disorder treated? 2. To what extent do the patient and other key persons consider discontinuation to be reasonable and will they support discontinuation? 3. Is the target complete withdrawal, a dose reduction or shift to another benzodiazepine drug which is more suitable in old age for pharmacokinetic reasons? This article provides assistance in answering these questions and some guidelines for the practical management of discontinuation...
February 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28039932/potentially-inappropriate-medications-in-elderly-japanese-patients-effects-of-pharmacists-assessment-and-intervention-based-on-screening-tool-of-older-persons-potentially-inappropriate-prescriptions-criteria-ver-2
#16
T Kimura, F Ogura, K Yamamoto, A Uda, T Nishioka, M Kume, H Makimoto, I Yano, M Hirai
WHAT IS KNOWN AND OBJECTIVES: The Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (stopp) criteria were updated in 2014 (stopp criteria ver.2), but few studies have evaluated the usefulness of stopp criteria in elderly patients. This prospective observational study evaluated the prevalence of potentially inappropriate medications (PIMs), and the efficacy of hospital pharmacists' assessment and intervention based on stopp criteria ver.2. METHODS: The study was conducted at three medical units of Kobe University Hospital between April 2015 and March 2016...
December 31, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27958259/immediate-resolution-of-acute-choreatic-hyperkinesias-following-intravenous-fentanyl
#17
J Finsterer, J Rettensteiner
Acute hyperkinesia after discontinuation of tramadol in a patient with chronic pain using citalopram and pramipexole for restless legs syndrome (RLS) has not been reported. An 81-year-old female was admitted for increasing hyperkinesias of the whole body after she had discontinued tramadol 300 mg (taken during 3 months) without tapering 4 days earlier. In addition, she was on treatment with pramipexole (0.18 mg) for RLS for years, citalopram 10 mg/day for ~4 years, and fentanyl 75 μg/day for 1 year. Hyperkinesias did not respond to benzodiazepines, quetiapine, biperiden, or valproic acid...
January 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/27956923/balneotherapy-together-with-a-psychoeducation-program-for-benzodiazepine-withdrawal-a-feasibility-study
#18
P De Maricourt, P Gorwood, Th Hergueta, A Galinowski, R Salamon, A Diallo, C Vaugeois, J P Lépine, J P Olié, O Dubois
Benzodiazepines should be prescribed on a short-term basis, but a significant proportion of patients (%) use them for more than 6 months, constituting a serious public health issue. Indeed, few strategies are effective in helping patients to discontinue long-term benzodiazepine treatments. The aim of this study was to assess the feasibility and the impact of a program including cognitive behavioural therapy, psychoeducation, and balneotherapy in a spa resort to facilitate long-term discontinuation of benzodiazepines...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/27862243/antidepressant-adherence-patterns-in-older-patients-use-of-a-clustering-method-on-a-prescription-database
#19
David Braunstein, Amélie Hardy, Quentin Boucherie, Elisabeth Frauger, Olivier Blin, Gaétan Gentile, Joëlle Micallef
According to the World Health Organization, depression will become the second most important cause of disability worldwide by 2020. Our objective was to identify patterns of adherence to antidepressant treatments in older patients using several indicators of adherence and to characterize these patterns in terms of medication exposure. We conducted a retrospective cohort study using the French National Health Insurance reimbursement database. Incident antidepressant users aged more than 65 were included from July 1, 2010, to June 30, 2011, and followed up for 18 months...
April 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/27848217/pregabalin-for-the-treatment-of-drug-and-alcohol-withdrawal-symptoms-a-comprehensive-review
#20
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...
December 2016: CNS Drugs
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