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Results for “Substance Withdrawal Syndrome”

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At least 19 recordsLinked to original sources
PubMedDate not supplied

[Correction of the symptoms of late substance withdrawal syndrome by intra-conjunctival administration of 5% homatropine solution (preliminary report)].

The "late" or post-acute alcohol withdrawal syndrome (PAWs) is characterized by recurring waves of psychosomatic disturbances, and return for alcohol for the relief of these symptoms is a commonplace in many of abstinent alcoholics. However, the exact mechanism(s) is not fully known and there is no established any rapid treatment. We now have some data which seem to confirm our original and successful experience with local homatropine in clearly defined cases of the PAW syndrome. 28 alcoholic inpatients suffering from severe signs of the post-acute alcohol withdrawal (PAW) syndrome were randomly administered either homatropine hydrobromide or placebo eyedrops. Administration of topical homatropine (two 0.5% drops were given twice being spaced 15 minutes apart), unlike that of placebo had, within 60 minutes, caused a significant and then usually maintained clinical improvement, as evidenced by decreases of intensity of the PAW symptoms (irritability, depressed mood, anxiety, somatic and vegetative disorders (p less than or equal to 0.01), as well as a considerable reduction of the self-rated "desire for drink" phenomenon (less than or equal to 0.01). Post-homatropine responses observed so far seem to be initiated by the reflexory-induced haemodynamic and thermoregulatory changes with a transient but still significant fall in the systolic blood pressure, pulse rate, and oral temperature. Of importance may be the fact that in majority of patients, the PAW symptoms decreased and well-being increased parallel with the fall in prolactin levels (p less than or equal to 0.01): this has usually been noted at 60 minutes after the first homatropine dosing and might indicate a possible involvement of, at least, the cholinergic-serotonergic pathways.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Benzodiazepine dependence and withdrawal: identification and medical management.

BACKGROUND: Primary care physicians prescribe benzodiazepines for the treatment of anxiety. Although most patients use the benzodiazepines appropriately, some patients experience benzodiazepine abuse, addiction, or physical dependence, each one of which is a distinct syndrome. Benzodiazepine dependence, which relates to the development of tolerance and an abstinence syndrome, can be produced by three disparate benzodiazepine use patterns. These distinct benzodiazepine use patterns can in turn create distinct withdrawal syndromes. High-dose benzodiazepine use between 1 and 6 months can produce an acute sedative-hypnotic withdrawal syndrome. In contrast, low-dose therapeutic range benzodiazepine use longer than 6 months can produce a prolonged, subacute low-dose benzodiazepine withdrawal syndrome. Daily, high-dose benzodiazepine use for more than 6 months can cause a combination of an acute high-dose benzodiazepine withdrawal and a prolonged, subacute low-dose withdrawal syndrome. In addition, patients may experience syndrome reemergence. METHODS: A literature search was conducted using the medical subject headings benzodiazepines, substance abuse, substance dependence, substance withdrawal syndrome, and benzodiazepines adverse effects. The years 1970 to the present were reviewed. RESULTS AND CONCLUSIONS: Medical management for acute benzodiazepine withdrawal includes the graded reduction of the current benzodiazepine dosage, substitution of a long-acting benzodiazepine, and phenobarbital substitution. However, the medical management of benzodiazepine dependence does not constitute treatment of benzodiazepine addiction. Primary care physicians can accept complete, moderate, or limited medical responsibility regarding patients with substance use disorders. However, all physicians should provide diagnostic and referral services.

Benzodiazepines↗
PubMed2000

Withdrawal syndromes.

The pathophysiology of substance withdrawal is elucidated by a review of classic and cutting-edge research. The manifestation and evaluation of the associated withdrawal syndromes from ethanol, sedative-hypnotics, opioids, and baclofen, are compared. The general management of and pharmacotherapy for these patients are discussed.

Alcohol Withdrawal Delirium↗
PubMedDate not supplied

Past mental health or substance use treatment history and psychiatric differential diagnosis in consultation-liaison patients.

The purpose of this study was to determine whether frequencies of any current primary or secondary (organic) psychiatric diagnoses in consultation-liaison (C-L) patients are associated with patient report of past history of mental health or substance use disorder treatment. Clinical information recorded in 134 C-L patients was retrospectively analyzed with the chi-square test, two-tailed, or Fisher's Exact Test when the sample sizes were < or = 5. The results revealed that the overall likelihood of the existence of a secondary psychiatric disorder diagnosis is elevated when there is no treatment history (P = 0.009). A primary psychiatric disorder is more likely to be diagnosed when there is treatment history (P = 0.009). Specific psychiatric diagnoses more likely to be present when there is no treatment history are organic mood disorder, depressed (P = 0.020) and adjustment disorder (P = 0.010). Specific diagnoses more likely to be present when there is treatment history are psychoactive substance-withdrawal syndrome (P = 0.014) and alcohol abuse or dependence (P = 0.028). The authors conclude that psychiatric treatment history can help C-L psychiatrists with differential diagnostic considerations.

Adolescent↗
PubMed1998

Rapid and ultrarapid opioid detoxification techniques.

OBJECTIVE: To review the scientific literature on the effectiveness of rapid opioid detoxification (RD) (opioid withdrawal precipitated by naloxone hydrochloride or naltrexone) and ultrarapid opioid detoxification (URD) (opioid withdrawal precipitated by naloxone or naltrexone under anesthesia or heavy sedation) techniques. DATA SOURCES: The MEDLINE database was searched from 1966 through 1997 using the indexing terms naloxone, naltrexone, substance dependence, and substance withdrawal syndrome. Additional data sources included bibliographies of papers identified on MEDLINE and bibliographies in textbooks on substance abuse. STUDY SELECTION: Inclusion criteria were studies of RD or URD, pharmacologic protocols specified, and clinical outcomes specified and reported. Exclusion criteria were unpublished data, data not in peer-reviewed journals, abstract-only publications, and review articles. DATA EXTRACTION: The methodologic characteristics of studies were extracted by the authors and summarized according to key components of research design concerning subject characteristics, therapy allocation, and outcomes assessed. DATA SYNTHESIS: A qualitative analysis was performed on the 12 studies of RD and the 9 studies of URD identified in our search. The RD studies enrolled 641 subjects (range for individual studies, 1-162): 7 were inpatient studies, and the protocols varied considerably, as did the outcomes assessed. Three RD studies included a control group, 2 used a randomized design, and 3 reported outcomes beyond 12 days. The URD studies enrolled 424 subjects (range for individual studies, 6-300): all were inpatient studies, the detoxification and anesthesia protocols varied, 3 included a control group, 2 used a randomized design, and 2 reported outcomes for URD beyond 7 days. CONCLUSIONS: The existing literature on RD and URD is limited in terms of the number of subjects evaluated, the variation in protocols studied, lack of randomized design and use of control groups, and the short-term nature of the outcomes reported. Further research is needed using more rigorous research methods, longer-term outcomes, and comparisons with other methods of treatment for opioid dependence.

Clinical Trials as Topic↗
PubMed2004

Review of the validity and significance of cannabis withdrawal syndrome.

The authors review the literature examining the validity and significance of cannabis withdrawal syndrome. Findings from animal laboratory research are briefly reviewed, and human laboratory and clinical studies are surveyed in more detail. Converging evidence from basic laboratory and clinical studies indicates that a withdrawal syndrome reliably follows discontinuation of chronic heavy use of cannabis or tetrahydrocannabinol. Common symptoms are primarily emotional and behavioral, although appetite change, weight loss, and physical discomfort are also frequently reported. The onset and time course of these symptoms appear similar to those of other substance withdrawal syndromes. The magnitude and severity of these symptoms appear substantial, and these findings suggest that the syndrome has clinical importance. Diagnostic criteria for cannabis withdrawal syndrome are proposed.

Ambulatory Care↗
PubMed2005

Heroin and diplopia.

AIMS: To describe the eye misalignments that occur during heroin use and heroin detoxification and to give an overview of the management of persisting diplopia (double vision) which results from eye misalignment. METHODS: A literature review using Medline and the search terms strabismus, heroin and substance withdrawal syndrome is presented. General management of cases presenting to the ophthalmologist and orthoptist with acute acquired concomitant esotropia is described. FINDINGS: A tendency towards a divergence of the visual axes appears to be present in heroin users, although when present it may not always lead to diplopia. Following detoxification intermittent esotropia or constant esotropia (convergence of the visual axes) can occur; if intermittent the angle tends to be small and diplopia present when viewing distance objects. Occlusion of one eye to eliminate the second image could encourage the development of a constant deviation. The deviation is not caused by a cranial nerve palsy. Constant deviations of this type are classified as 'acute acquired concomitant esotropia'. Relief from the diplopia may be gained by prismatic correction, and the deviation may then resolve spontaneously. Botulinum toxin or surgical intervention may be necessary in cases that do not resolve. CONCLUSIONS: Heroin use may lead to intermittent or constant exotropia and withdrawal may result in intermittent or constant esotropia. Awareness of the mechanism causing this may avoid referral to other specialties (e.g. neurology) and awareness of treatment modalities could encourage patients to seek appropriate help for relief of symptoms.

Acute Disease↗
PubMed2003

Prolonged dexmedetomidine infusion as an adjunct in treating sedation-induced withdrawal.

IMPLICATIONS: Dexmedetomidine, an alpha(2)-adrenoceptor agonist, is indicated for sedating patients on mechanical ventilation. It has been approved by the Food and Drug Administration for 24-h use. This is a report concerning a patient in whom a continuous infusion of dexmedetomidine was safely used for a week to help in averting frank withdrawal symptoms from an opioid and benzodiazepines.

Acinetobacter Infections↗
PubMed1990

Carbamazepine monotherapy in the treatment of alcohol withdrawal.

More than 135 different strategies for medical treatment have been described for the treatment of alcohol withdrawal syndromes. The substances used most frequently (benzodiazepines, barbiturates, or clomethiazol) themselves pose some risk for abuse or addiction. Anticonvulsants, especially carbamazepine (CBZ), have been discussed for the treatment of alcohol withdrawal since the early seventies. Various studies report favourable results with CBZ, usually combined with sedative agents. Nineteen out-patients and 19 in-patients took part in an open study of CBZ in alcohol withdrawal. The dose of CBZ was adjusted individually and ranged from a mean dose of 761 mg on day 1 to 616 mg on day 3 and to 388 mg on day 7 in the group of out-patients, and from 789 mg on day 1, 694 mg on day 3 to 562 mg on day 7 in the sample of in-patients. The "Objective Clinical Scale in Assessment and Measurement of Alcohol Withdrawal" (OCSAMAW) was used for treatment evaluation. Statistical analysis showed a significant improvement on the 5%-level in both groups; four in-patients needed concomitant treatment with oxazepam. Nausea and pruritus were the most common side-effects of CBZ treatment.

Adult↗
PubMed2005

Treatment of alcohol withdrawal syndrome with combined carbamazepine and tiapride in a patient with probable sleep apnoe syndrome.

The most frequently used agents for treatment of alcohol withdrawal syndrome are benzodiazepines and clomethiazole. Both have the main disadvantage of potential misuse and respiratory depression. Therefore their use in patients with respiratory diseases is limited. In recent years a treatment strategy with combined carbamazepine and tiapride was reported to be an effective alternative in alcohol withdrawal without the risk of respiratory depression. We report the successful treatment with carbamazepine and tiapride of a patient with probable sleep apnoe syndrome and history of withdrawal-related epileptic seizures.

Aged↗