PubMed Health⌕ Search

Biomedical subjects

S Apelt

Publications and source records attributed to S Apelt.

8 recordsLinked to original sources
PubMed1992

[Psychopharmacology and clinical aspects of benzodiazepine dependence].

Recent aspects of mechanism of benzodiazepines (BDZ) via indirect GABA-mimetic inhibitory effects at brain-specific BDZ-GABA receptors may contribute to an understanding of pathophysiological mechanisms of anxiety disorders and drug dependencies. The development of various BDZ receptor ligands with diverse psychopharmacological properties may lead to safer drugs with regard to "drug seeking" and "maintaining" properties. This paper reviews recent research of BDZ receptor pharmacology and clinical aspects of abstinence syndromes including also prospective studies.

Anti-Anxiety Agents↗
PubMed1991

Treatment of benzodiazepine withdrawal symptoms with carbamazepine.

In 18 patients with a benzodiazepine (BZD) dependency the drug was withdrawn. The dose of BZD was gradually reduced in nine of the patients, while the others were additionally treated with carbamazepine (CBZ) for a further 15 days after BZD discontinuation. Withdrawal symptoms were assessed every third day during the study period. When comparing results in both groups, a clear trend towards less severe withdrawal symptoms could be observed in the group treated with CBZ. Some of the differences were statistically significant on days 9-12 after BZD withdrawal. Fundamental withdrawal symptoms (like hypersensitivity to sensory stimuli, abnormal perception of movement, depersonalisation or derealisation) were also less severe in the group treated with CBZ compared with the group not receiving that treatment. These findings support the results of previous reports indicating a therapeutical effect of CBZ in BZD withdrawal.

Adult↗
PubMed1990

Preference for alprazolam as opposed to diazepam in benzodiazepine-dependent psychiatric inpatients.

Fourteen inpatients with long-term benzodiazepine (BDZ)-dependency were gradually withdrawn from their medication. During a four-day study period patients received 5 mg diazepam t.d.s. Under double-blind conditions the 5 mg diazepam was replaced twice, by either 0.5 mg or 0.37 mg alprazolam. When the hypothetically realistic alprazolam to diazepam equivalent ratio of 1:10 with regard to hypnosedative and anxiolytic properties was used, alprazolam was clearly preferred to diazepam in three sensitive tests. When alprazolam and diazepam were tested using the altered equivalent ratio of 1:14, "liking" and "seeking potentials" revealed no significant differences. However, also under these test conditions alprazolam tended to be preferred in a drug choice test. It is concluded that alprazolam appears to implicate somewhat higher reinforcing properties, possibly leading to a higher abuse liability in BDZ-dependent patients as compared to diazepam.

Adult↗
PubMed1987

Carbamazepine as an adjunct of antipsychotic therapy.

The effect of low-dose haloperidol combined with the anticonvulsant carbamazepine was investigated in a 5-week placebo-controlled, double-blind study in acute schizophrenic patients. Weekly ratings showed a clinically pronounced and statistically significant improvement in both the carbamazepine and placebo groups. However, the patients on carbamazepine needed less neuroleptic and anticholinergic medication and experienced fewer side effects compared to the patients on placebo. Moreover, patients in the carbamazepine group showed a clear deterioration after discontinuation of carbamazepine (but maintenance of neuroleptic medication), while the placebo group did not change after discontinuation of placebo. Concomitant treatment with carbamazepine in psychotic patients may help to reduce neuroleptic dosages and unwanted side effects.

Adjuvants, Pharmaceutic↗
PubMed1987

Characterization of benzodiazepine withdrawal in high- and low-dose dependent psychiatric inpatients.

Fourteen patients with high- (n = 7) and low-dose (n = 7) benzodiazepine (BDZ) dependency presented predominantly with anxious and depressive neurotic symptoms which caused long-term BDZ medication. Their BDZ dependency was characterized by giving preference to the abuse of benzodiazepines with long elimination half-life. Significant enlargement of CSF spaces was only found in high-dose dependent patients. Withdrawal after long-term BDZ medication revealed no differences between high- and low-dose BDZ dependency with respect to onset of withdrawal reaction and the correlation between onset of withdrawal and peak fall of BDZ serum level. The peak of withdrawal was reached 3-4 days later in high-dose BDZ dependent patients compared with those with a low-dose dependency. The peak withdrawal in high-dose dependent patients appeared when the serum BDZ metabolite nordiazepam dropped significantly. No such concomitant appearance of peak withdrawal and drop of serum nordiazepam level could be found in low-dose dependent patients. Specificity and intensity of BDZ withdrawal symptoms were the same for those dependent upon high doses of BDZs and those dependent upon low doses, but a protracted withdrawal was only observed in low-dose BDZ-dependent patients. During the withdrawal period psychopathometric measurements consistently revealed parallel changes in the scores for physical withdrawal symptoms, anxiety and depression. It is not clear whether anxiety and depression are "typical" BDZ withdrawal reactions or represent a "reactivated" state of the psychopathological disturbance which lead to the BDZ dependency. Possible implications for the therapeutical management of BDZ-dependent patients are discussed.

Adult↗