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benzodiazepines discontinuation

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https://www.readbyqxmd.com/read/29626743/examining-racial-ethnic-differences-in-patterns-of-benzodiazepine-prescription-and-misuse
#1
Benjamin Cook, Timothy Creedon, Ye Wang, Chunling Lu, Nicholas Carson, Piter Jules, Esther Lee, Margarita Alegría
BACKGROUND: Benzodiazepines (BZDs) are widely prescribed during psychiatric treatment. Unfortunately, their misuse has led to recent surges in overdose emergency visits and drug-related deaths. METHODS: Electronic health record data from a large healthcare system were used to describe racial/ethnic, sex, and age differences in BZD use and dependence. Among patients with a BZD prescription, we assessed differences in the likelihood of subsequently receiving a BZD dependence diagnosis, number of BZD prescriptions, receiving only one BZD prescription, and receiving 18 or more BZD prescriptions...
March 26, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29568537/a-province-wide-cross-sectional-study-of-demographics-and-medication-use-of-patients-in-hemodialysis-units-across-ontario
#2
Marisa Battistella, Racquel Jandoc, Jeremy Y Ng, Eric McArthur, Amit X Garg
Background: Hemodialysis patients are at an increased risk of polypharmacy as they have the highest pill burden of all chronically ill patient populations, with an estimated average of 12 medications per day. Objectives: The aim of this study was to evaluate prescribing patterns of outpatient medications in patients receiving in-center hemodialysis. This was done to identify potential candidate medications for future quality improvement initiations to optimize prescribing...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29543325/pharmacological-interventions-for-benzodiazepine-discontinuation-in-chronic-benzodiazepine-users
#3
REVIEW
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
https://www.readbyqxmd.com/read/29530369/adherence-and-persistence-to-ropinirole-pramipexole-and-gabapentin-in-patients-with-newly-diagnosed-restless-legs-syndrome
#4
Juhyeun Kim, Abraham G Hartzema
STUDY OBJECTIVES: The objective of this study is to assess adherence and persistence of ropinirole, pramipexole, and gabapentin; to investigate factors associated with non-adherence and non-persistence in restless legs syndrome (RLS) patients. METHODS: We used the 2008-2014 Marketscan® Research Databases to conduct a retrospective data analysis. The study included newly diagnosed RLS patients who initiated ropinirole, pramipexole, or gabapentin therapy. During 365 days of follow-up, mean medication possession ratios (MPRs) for adherence and the proportion of adherent users were calculated...
April 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29487083/drugs-for-insomnia-beyond-benzodiazepines-pharmacology-clinical-applications-and-discovery
#5
REVIEW
Tobias Atkin, Stefano Comai, Gabriella Gobbi
Although the GABAergic benzodiazepines (BZDs) and Z-drugs (zolpidem, zopiclone, and zaleplon) are FDA-approved for insomnia disorders with a strong evidence base, they have many side effects, including cognitive impairment, tolerance, rebound insomnia upon discontinuation, car accidents/falls, abuse, and dependence liability. Consequently, the clinical use of off-label drugs and novel drugs that do not target the GABAergic system is increasing. The purpose of this review is to analyze the neurobiological and clinical evidence of pharmacological treatments of insomnia, excluding the BZDs and Z-drugs...
April 2018: Pharmacological Reviews
https://www.readbyqxmd.com/read/29442341/the-influence-of-hospitalisation-on-the-initiation-continuation-and-discontinuation-of-benzodiazepines-and-z-drugs-an-observational-study
#6
Thomas Grimmsmann, Markus Harden, Thomas Fiß, Wolfgang Himmel
BACKGROUND AND OBJECTIVES: Hospitalisation influences drug therapy in ambulatory care and this influence is generally negatively perceived. The few studies that have explored changes in benzodiazepine or sleep medication use as a function of hospitalisation failed to precisely determine the hospital's role in initiating, continuing and discontinuing these drugs on a valid basis. The aim of the study was to ascertain the overall influence of hospitalisation on the prescription of benzodiazepines and Z-drugs in outpatient care with a special focus on the role of different hospital departments and drug classes...
February 14, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29385766/benzodiazepines-ii-waking-up-on-sedatives-providing-optimal-care-when-inheriting-benzodiazepine-prescriptions-in-transfer-patients
#7
REVIEW
Jeffrey Guina, Brian Merrill
This review discusses risks, benefits, and alternatives in patients already taking benzodiazepines when care transfers to a new clinician. Prescribers have the decision-sometimes mutually agreed-upon and sometimes unilateral-to continue, discontinue, or change treatment. This decision should be made based on evidence-based indications (conditions and timeframes), comorbidities, potential drug-drug interactions, and evidence of adverse effects, misuse, abuse, dependence, or diversion. We discuss management tools involved in continuation (e...
January 30, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29336611/interventions-to-improve-benzodiazepine-tapering-success-in-the-elderly-a-systematic-review
#8
Carol Dou, Johannes Rebane, Stan Bardal
BACKGROUND: Long-term benzodiazepine use in the elderly population is a significant public health problem that leads to impaired cognitive functioning, medication dependence and increased risks for adverse drug reactions. The aim of this review was to examine randomized controlled trials (RCTs) on the efficacy of different methods for tapering and discontinuing benzodiazepines. METHOD: We used four databases (Ovid, PubMed, Academic Search Complete, Web of Science) to retrieve randomized controlled trials published in peer-reviewed journals that explored different methods for tapering benzodiazepine use in a primarily geriatric population...
January 16, 2018: Aging & Mental Health
https://www.readbyqxmd.com/read/29317396/pregabalin-as-adjunctive-therapy-in-benzodiazepine-discontinuation
#9
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
https://www.readbyqxmd.com/read/29310960/cannabinoid-hyperemesis-syndrome-pathophysiology-and-treatment-in-the-emergency-department
#10
John R Richards
BACKGROUND: Cannabinoid hyperemesis syndrome (CHS) is a challenging clinical disorder. CHS patients frequently present to the emergency department and may require treatment for intractable emesis, dehydration, and electrolyte abnormalities. Thought to be a variant of cyclic vomiting syndrome, CHS has become more prevalent with increasing cannabis potency and use, as enabled by various states having legalized the recreational use of cannabis. OBJECTIVE: This aim of this review is to investigate the pathophysiology of CHS and evaluate the published literature on pharmacologic treatment in the emergency department...
March 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29290746/prolonged-dexmedetomidine-infusion-and-drug-withdrawal-in-critically-ill-children
#11
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
https://www.readbyqxmd.com/read/29281047/symptom-triggered-detoxification-using-the-alcohol-withdrawal-scale-reduces-risks-and-healthcare-costs
#12
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
https://www.readbyqxmd.com/read/29223863/what-can-predict-and-prevent-the-long-term-use-of-benzodiazepines
#13
Takeo Hata, Tetsufumi Kanazawa, Takeshi Hamada, Masami Nishihara, Ashley Ian Bush, Hiroshi Yoneda, Miki Nakajima, Takahiro Katsumata
Although benzodiazepines (BZDs) are commonly prescribed for insomnia or anxiety, long-term use of BZDs causes serious adverse effects such as daytime drowsiness and cognitive decline. In the current study, we evaluated the predictors and preventers of long-term usage of BZDs from a retrospective survey by utilizing the 12-year prescription record of a university hospital. From the prescription data of 92,005 people, users of BZDs (n = 3,470, male = 39.2%, mean age = 60 ± 17.5) were analyzed. During this period, both the number of prescriptions (2722 in 2004 to 1019 in 2016) and the number of BZDs (1...
February 2018: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/29193185/ketamine-infusion-for-adjunct-sedation-in-mechanically-ventilated-adults
#14
Lara M Groetzinger, Ryan M Rivosecchi, William Bain, Marshall Bahr, Katherine Chin, Bryan J McVerry, Ian Barbash
BACKGROUND: Many critically ill patients receive ketamine for adjunct sedation despite a paucity of evidence on its use, dosing, and monitoring in this setting. OBJECTIVE: To describe the dosing and safety considerations of ketamine for adjunct sedation in a population of mechanically ventilated critically ill patients targeting light sedation. METHODS: We conducted a retrospective review of mechanically ventilated patients receiving continuous ketamine infusion between January 2012 and April 2016...
February 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29127459/the-use-of-an-electronic-clinical-rule-to-discontinue-chronically-used-benzodiazepines-and-related-z-drugs
#15
C Mestres Gonzalvo, V Milosevic, B P C van Oijen, H A J M de Wit, K P G M Hurkens, W J Mulder, R Janknegt, J M G A Schols, F R Verhey, B Winkens, P H M van der Kuy
PURPOSE: The chronic use of benzodiazepines and benzodiazepine-related drugs (BZ/Z) in older people is common and not without risks. The objective of this study was to evaluate whether the implementation of a clinical rule promotes the discontinuation of chronically used BZ/Z for insomnia. METHODS: A clinical rule, generating an alert in case of chronic BZ/Z use, was created and applied to the nursing home (NH) setting. The clinical rule was a one-off intervention, and alerts did not occur over time...
February 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28988167/financial-incentives-to-discontinue-long-term-benzodiazepine-use-a-discrete-choice-experiment-investigating-patient-preferences-and-willingness-to-participate
#16
Joachim Marti, Marcus Bachhuber, Jordyn Feingold, David Meads, Michael Richards, Sean Hennessy
OBJECTIVES: Investigate the acceptability of financial incentives for initiating a medically supervised benzodiazepine discontinuation programme among people with long-term benzodiazepine use and to identify programme features that influence willingness to participate. METHODS: We conducted a discrete choice experiment in which we presented a variety of incentive-based programs to a sample of older adults with long-term benzodiazepine use identified using the outpatient electronic health record of a university-owned health system...
October 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28891380/stories-of-hell-and-healing-internet-users-construction-of-benzodiazepine-distress-and-withdrawal
#17
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/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/28807135/suicidal-ideation-and-suicidal-self-directed-violence-following-clinician-initiated-prescription-opioid-discontinuation-among-long-term-opioid-users
#19
Michael I Demidenko, Steven K Dobscha, Benjamin J Morasco, Thomas H A Meath, Mark A Ilgen, Travis I Lovejoy
OBJECTIVE: Little is known about patient outcomes following discontinuation of opioid therapy, which may include suicidal ideation (SI) and suicidal self-directed violence (SSV). The purpose of this study was to examine correlates of SI and non-fatal SSV in a sample of patients discontinued from long-term opioid therapy (LTOT). METHOD: Five hundred-nine Veterans Health Administration (VHA) patients whose clinicians discontinued them from LTOT were selected from a national cohort of VHA patients who discontinued opioids in 2012...
July 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28802513/nonconvulsive-status-epilepticus-after-electroconvulsive-therapy-a-review-of-literature
#20
REVIEW
Awais Aftab, Ashley VanDercar, Ayham Alkhachroum, Christine LaGrotta, Keming Gao
BACKGROUND: The clinical presentation and risk factors of nonconvulsive status epilepticus (NCSE) in the context of electroconvulsive therapy (ECT) are poorly understood, and guidance regarding diagnosis and management remains scarce. In this article, we identify case reports of ECT-induced NCSE from literature, and discuss the presentation, diagnosis, and management of these cases in the context of what is known about NCSE from the neurology literature. METHODS: A literature search on PubMed for case reports of NCSE after ECT...
January 2018: Psychosomatics
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