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benzodiazepines discontinuation

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https://www.readbyqxmd.com/read/28182456/the-impact-of-service-connected-disability-and-therapist-experience-on-outcomes-from-prolonged-exposure-therapy-with-veterans
#1
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
#2
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
#3
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...
February 2, 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
#4
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
#5
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)...
January 25, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28105500/-discontinuation-of-benzodiazepines-in-old-age-when-and-if-so-how
#6
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
#7
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
#8
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
#9
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
#10
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 term 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...
November 14, 2016: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/27848217/pregabalin-for-the-treatment-of-drug-and-alcohol-withdrawal-symptoms-a-comprehensive-review
#11
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
https://www.readbyqxmd.com/read/27818367/varied-responses-to-benzodiazepine-treatment-in-cephalosporin-related-generalized-periodic-discharges
#12
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...
December 1, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/27814838/benzodiazepine-use-in-older-adults-dangers-management-and-alternative-therapies
#13
REVIEW
Matej Markota, Teresa A Rummans, John Michael Bostwick, Maria I Lapid
Several major medical and psychiatric organizations, including the American Geriatrics Society, advise against using benzodiazepines or nonbenzodiazepine hypnotics in older adults. Despite these recommendations, benzodiazepines continue to be massively prescribed to a group with the highest risk of serious adverse effects from these medications. This article summarizes legitimate reasons for prescribing benzodiazepines in the elderly, serious associated risks of prescribing them, particularly when not indicated, barriers physicians encounter in changing their prescription patterns, and evidence-based strategies on how to discontinue benzodiazepines in older patients...
November 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27741029/long-term-use-of-antipsychotics-in-community-dwelling-dementia-patients-prevalence-and-profile-accounting-for-unobservable-time-bias-because-of-hospitalization
#14
Quentin Boucherie, Gaëtan Gentile, Coralie Chalançon, Vincent Sciortino, Olivier Blin, Joëlle Micallef, Sylvie Bonin-Guillaume
The aim of this study was to assess the prevalence of long-term antipsychotic (AP) use in community-dwelling patients with dementia considering hospitalization periods as AP exposure or not. A retrospective study was carried out from 2009 to 2012 on a PACA-Alzheimer cohort (which included 31 963 patients in 2009 and 36 442 in 2012 from 5 million inhabitants). Three groups of patients were identified according to the longest exposure to APs without interruption: nonusers, short-term users (≤3 successive months without discontinuation), and long-term users...
January 2017: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27702420/clinical-management-of-restless-legs-syndrome-in-end-stage-renal-disease-patients
#15
Zeyad T Sahli, Jae Jo, Shaker A Mousa, Frank I Tarazi
Restless legs syndrome (RLS) is a common neurological movement disorder, characterized by restless and unpleasant sensations in the deep inside of legs. The symptoms of RLS are less noticeable during daytime, but more prevalent at night. Therefore, the disorder can induce low quality of life, insomnia, and impairment of daytime activity. RLS in end-stage renal disease (ESRD) patients is especially problematic due to premature discontinuation of dialysis and increased mortality. The prevalence of RLS among dialysis patients is much higher compared to the prevalence of the same disorder in patients with normal renal functions...
October 5, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27558857/survey-of-primary-care-and-mental-health-prescribers-perspectives-on-reducing-opioid-and-benzodiazepine-co-prescribing-among-veterans
#16
Eric J Hawkins, Carol A Malte, Hildi J Hagedorn, Douglas Berger, Anissa Frank, Aline Lott, Carol E Achtmeyer, Anthony J Mariano, Andrew J Saxon
BACKGROUND:  Due to the involvement of opioids and benzodiazepines in rising pharmaceutical overdoses, a reduction in coprescribing of these medications is a national priority, particularly among patients with substance use disorders and other high-risk conditions. However, little is known about primary care (PC) and mental health (MH) prescribers' perspectives on these medications and efforts being implemented to reduce coprescribing. DESIGN:  An anonymous survey...
August 24, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27549604/benzodiazepine-misuse-in-the-elderly-risk-factors-consequences-and-management
#17
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/27471419/novel-class-of-medications-orexin-receptor-antagonists-in-the-treatment-of-insomnia-critical-appraisal-of-suvorexant
#18
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/27333965/serotonin-syndrome-induced-by-combined-use-of-mirtazapine-and-olanzapine-complicated-with-rhabdomyolysis-acute-renal-failure-and-acute-pulmonary-edema-a-case-report
#19
REVIEW
Chi-Shun Wu, Show-Hwa Tong, Cheung-Ter Ong, Sheng-Feng Sung
PURPOSE: Serotonin syndrome is a potentially life-threatening complication of serotonergic agents. Although mirtazapine is a relatively safe antidepressant and has a comparatively low incidence of side effects, it still could induce serotonin syndrome. CASE REPORT: We described a 34-year-old man with schizophrenic disorder who presented with acute consciousness disturbance, extremely high fever, rigidity, and spontaneous clonus in lower limbs. Two days before entry, oral mirtazapine was added to his regular medication of olanzapine...
December 2015: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/27307740/comparison-of-clinical-features-between-primary-and-drug-induced-sleep-related-eating-disorder
#20
Yoko Komada, Yoshikazu Takaesu, Kentaro Matsui, Masaki Nakamura, Shingo Nishida, Meri Kanno, Akira Usui, Yuichi Inoue
PURPOSE: The aim of this study was to ascertain the clinical characteristics of drug-induced sleep-related eating disorder (SRED). PATIENTS AND METHODS: We retrospectively reviewed the medical records of 30 patients with primary SRED (without any comorbid sleep disorders and who were not taking any possible causative medications), and ten patients with drug-induced SRED (occurrence of SRED episodes after starting nightly medication of sedative drugs, which completely resolved after dose reduction or discontinuation of the sedatives)...
2016: Neuropsychiatric Disease and Treatment
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