“Carga de diazepam”: ¿puede una estrategia para prevenir abstinencia al alcohol usarse con éxito para tratar la dependencia a benzodiacepinas?

Oliveras, Clara; Fortea, Adriana; Espinosa, Laura; Barrio, Pablo; Lligoña, Anna; Balcells‐Oliveró, Mercè

doi:10.20882/adicciones.1058

Cited by 4 publications

(2 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Tras haber leído con interés y atención la reciente carta al editor publicada en esta revista "Carga de diacepam: ¿puede una estrategia para prevenir abstinencia al alcohol usarse con éxito para tratar la dependencia a benzodiacepinas?" (Oliveras et al, 2018) quisiéramos hacer una serie de consideraciones al respecto.…”

Section: S R Editorunclassified

Consideraciones respecto al uso de dosis de carga de diazepam para el tratamiento de la dependencia a benzodiacepinas

Balmori¹,

Álvarez

Turiel

et al. 2018

Adicciones

View full text Add to dashboard Cite

show abstract

Section: S R Editorunclassified

Consideraciones respecto al uso de dosis de carga de diazepam para el tratamiento de la dependencia a benzodiacepinas

Balmori¹,

Álvarez

Turiel

et al. 2018

Adicciones

View full text Add to dashboard Cite

show abstract

“…However, such a distinction has never been attempted in practice. Despite the knowledge about extensive individual variations in long-acting BZD elimination times, concentration tracking, unless for toxicological reasons, is currently observed rarely and only on a case-bycase basis [26,27].…”

Section: Introductionmentioning

confidence: 99%

Delayed crises following benzodiazepine withdrawal: deficient adaptive mechanisms or simple pharmacokinetics? Detoxification assisted by serum-benzodiazepine elimination tracking

Basińska-Szafrańska

2021

Eur J Clin Pharmacol

View full text Add to dashboard Cite

Objective Rapid relapses after successful withdrawal occur even in apparently motivated benzodiazepine (BZD)-dependent patients. Regardless of known personality or biological (re-adaptation) issues, the aim of this open-label, single-arm, seminaturalistic study was to search for any detoxification errors contributing to failures. Methods The data came from 350 inpatients. Based on serum-BZD evolution criteria, the procedure was divided into four stages: substitution, accumulation, elimination and post-elimination observation. After switching the patients to a long-acting substitute (diazepam), to prevent data falsification due to unwanted overaccumulation, the doses were expeditiously reduced under laboratory feedback until accumulation stopped. With the start of effective elimination, the tapering rate slowed and was individually adjusted to the patient’s current clinical state. The tracking of both serum-BZD concentration and the corresponding intensity of withdrawal symptoms was continued throughout the entire elimination phase, also following successful drug withdrawal. Detoxification was concluded only after the patient's post-elimination stabilization. Results Regardless of various initial serum-BZD concentration levels and the customized dose-reduction rate, and despite the novel lab-driven actions preventing initial overaccumulation, elimination was systematically proven to be protracted and varied within the 2- to 95-day range after the final dose. Within this period, withdrawal syndrome culminated several times, with varying combinations of symptoms. The last crisis occurrence (typically 2–3 weeks after withdrawal) correlated with the final serum-BZD elimination. The factors that prolonged elimination and delayed the final crisis were patient age, duration of addiction, adjunct valproate medication and elimination stage start parameters growing with former overaccumulation. Conclusions The low-concentration detoxification stage is critical for patients’ confrontations with recurring withdrawal symptoms. Underestimated elimination time following drug withdrawal and premature conclusions of detoxification expose patients to unassisted withdrawal crises. Concentration tracking defines proper limits for medical assistance, preventing early relapses.

show abstract

Metabolic diversity as a reason for unsuccessful detoxification from benzodiazepines: the rationale for serum BZD concentration monitoring

Basińska-Szafrańska

2021

Eur J Clin Pharmacol

View full text Add to dashboard Cite

“Carga de diazepam”: ¿puede una estrategia para prevenir abstinencia al alcohol usarse con éxito para tratar la dependencia a benzodiacepinas?

Cited by 4 publications

References 3 publications

Consideraciones respecto al uso de dosis de carga de diazepam para el tratamiento de la dependencia a benzodiacepinas

Consideraciones respecto al uso de dosis de carga de diazepam para el tratamiento de la dependencia a benzodiacepinas

Delayed crises following benzodiazepine withdrawal: deficient adaptive mechanisms or simple pharmacokinetics? Detoxification assisted by serum-benzodiazepine elimination tracking

Metabolic diversity as a reason for unsuccessful detoxification from benzodiazepines: the rationale for serum BZD concentration monitoring

Contact Info

Product

Resources

About