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benzodiazepines discontinuation

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https://www.readbyqxmd.com/read/29442341/the-influence-of-hospitalisation-on-the-initiation-continuation-and-discontinuation-of-benzodiazepines-and-z-drugs-an-observational-study
#1
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
#2
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
#3
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
#4
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
#5
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...
January 5, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29290746/prolonged-dexmedetomidine-infusion-and-drug-withdrawal-in-critically-ill-children
#6
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
#7
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
#8
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
#9
Lara M Groetzinger, Ryan M Rivosecchi, William Bain, Marshall Bahr, Katherine Chin, Ian Barbash, Bryan J McVerry
BACKGROUND: Many critically ill patients receive ketamine for adjunct sedation despite a paucity of evidence on its usage, 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...
November 29, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29127459/the-use-of-an-electronic-clinical-rule-to-discontinue-chronically-used-benzodiazepines-and-related-z-drugs
#10
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...
November 10, 2017: 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
#11
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
#12
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
#13
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
#14
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
#15
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...
July 15, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28767528/should-benzodiazepines-and-anticonvulsants-be-used-during-electroconvulsive-therapy-a-case-study-and-literature-review
#16
Victor M Tang, Akash N Pasricha, Daniel M Blumberger, Daphne Voineskos, Suvercha Pasricha, Benoit H Mulsant, Zafiris J Daskalakis
OBJECTIVE: This study aims to investigate the clinical effects of benzodiazepines or anticonvulsant use during a course of electroconvulsive therapy (ECT). METHOD: A case report study of a patient who received ECT with and without concomitant flurazepam and pregabalin is presented. The literature on the use of benzodiazepines and anticonvulsants during ECT is reviewed. RESULTS: A woman with treatment resistant depression received a course of ECT while taking flurazepam and pregabalin, but seizures were of short duration and symptomatic improvement was minimal...
December 2017: Journal of ECT
https://www.readbyqxmd.com/read/28752589/frailty-and-potentially-inappropriate-medication-use-at-nursing-home-transition
#17
Laura C Maclagan, Colleen J Maxwell, Sima Gandhi, Jun Guan, Chaim M Bell, David B Hogan, Nick Daneman, Sudeep S Gill, Andrew M Morris, Lianne Jeffs, Michael A Campitelli, Dallas P Seitz, Susan E Bronskill
BACKGROUND/OBJECTIVES: To estimate the prevalence of potentially inappropriate medication (PIM) use among older adults with cognitive impairment or dementia prior to and following admission to nursing homes and in relation to frailty. DESIGN: Retrospective cohort study using health administrative databases. SETTING: Ontario, Canada. PARTICIPANTS: 41,351 individuals with cognitive impairment or dementia, aged 66+ years newly admitted to nursing home between 2011 and 2014...
October 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28617210/antipsychotic-medication-use-among-publicly-insured-pregnant-women-in-the-united-states
#18
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...
November 1, 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
#19
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...
July 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28570796/neonatal-discontinuation-syndrome-in-serotonergic-antidepressant-exposed-neonates
#20
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
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