Benzodiazepine dependence: Focus on withdrawal syndrome

Authier, Nicolas; Balayssac, David; Sautereau, Marie; Zangarelli, Aude; Courty, Pascal; Somogyi, A.; Vennat, B.; Llorca, Pierre‐Michel; Eschalier, Alain

doi:10.1016/j.pharma.2009.07.001

Cited by 56 publications

(36 citation statements)

References 24 publications

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“…Currently the pharmacological treatment of anxiety mainly relies on the benzodiazepines [33]. However, for well-known reason, there is a great limitation in chronic using of benzodiazepines [34]. …”

Section: Discussionmentioning

confidence: 99%

Acupuncture Attenuates Anxiety‐Like Behavior by Normalizing Amygdaloid Catecholamines during Ethanol Withdrawal in Rats

Zhao

et al. 2011

Evidence-Based Complementary and Alternative Medicine

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Previously, we demonstrated acupuncture at acupoint HT7 (Shen-Men) attenuated ethanol withdrawal syndrome by normalizing the dopamine release in nucleus accumbens shell. In the present study, we investigated the effect of acupuncture on anxiety-like behavior in rats and its relevant mechanism by studying neuro-endocrine parameters during ethanol withdrawal. Rats were treated with 3 g kg−1day−1 of ethanol (20%, w/v) or saline by intraperitoneal injections for 28 days. The rats undergoing ethanol withdrawal exhibited anxiety-like behavior 72 h after the last dose of ethanol characterized by the decrease of time spent in the open arms of the elevated plus maze compared with the saline-treated rats (P < .05). Radioimmunoassay exhibited there were notably increased concentrations of plasma corticosterone in ethanol-withdrawn rats compared with saline-treated rats (P < .05). Additionally, high performance liquid chromatography analysis also showed the levels of norepinephrine and 3-methoxy-4-hydroxy-phenylglycol were markedly increased while the levels of dopamine and 3,4-dihydroxyphenylacetic acid were significantly decreased in the central nucleus of the amygdala of ethanol-withdrawn rats compared with saline-treated rats (P < .01). Acupuncture groups were treated with acupuncture at acupoint HT7 or PC6 (Nei-Guan). Acupuncture at HT7 but not PC6 greatly attenuated the anxiety-like behavior during ethanol withdrawal as evidenced by significant increases in the percentage of time spent in open arms (P < .05). In the meantime, acupuncture at HT7 also markedly inhibited the alterations of neuro-endocrine parameters induced by ethanol withdrawal (P < .05). These results suggest that acupuncture may attenuate anxiety-like behavior during ethanol withdrawal through regulation of neuro-endocrine system.

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Section: Discussionmentioning

confidence: 99%

Acupuncture Attenuates Anxiety‐Like Behavior by Normalizing Amygdaloid Catecholamines during Ethanol Withdrawal in Rats

Zhao

et al. 2011

Evidence-Based Complementary and Alternative Medicine

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“…4 Another factor that may favor increased use of BDZ is free distribution by the public health system, since this makes them accessible to a large population, and is associated with a lack of protocols to guide prescribing and dispensing. 5 Benzodiazepines have a high potential for addiction, 6 which is related to their pharmacokinetics. 7 The higher the lipid solubility and lower the half-life, the greater the potential for drug dependence, and since lipid solubility is what determines the absorption rate and the speed and extent of drug delivery, it is an important feature of BDZ, which have good tissue distribution and cross the blood-brain barrier easily.…”

Section: Introductionmentioning

confidence: 99%

Assessment of dependence and anxiety among benzodiazepine users in a provincial municipality in Rio Grande do Sul, Brazil

Schallemberger

Colet

2016

Trends Psychiatry Psychother.

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Introduction: Benzodiazepines are among the most prescribed drugs for anxiety and one of the most used drug classes in the world and have a high potential for addiction. The objective of this study was to assess levels of dependence and anxiety among users of these drugs in the public health system. Methods: This was a cross-sectional, descriptive and quantitative study. Benzodiazepine users treated on the public health system were selected. Anxiety levels were assessed with the Hamilton Anxiety Scale and dependency with the Benzodiazepine Dependence Self-Report Questionnaire. Results: Benzodiazepine use was higher among women and in older age groups. Duration of benzodiazepine use was greater than 1 year for all respondents. The dependence assessment indicated that more than half of users were dependent on taking benzodiazepines and most had a severe degree of anxiety. Conclusion: This study found evidence of prolonged and inappropriate use of benzodiazepines. It is necessary to educate users about the risks of these drugs and to develop strategies to rationalize use of these drugs by working with prescribers and dispensers.

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“…Increase in cognitive competencies couldn't be measured nor evaluated due to the original severity of intellectual disability. Nonetheless, patients showed no worsening of their behavioral disorder [10] after the total and complete discontinuance.…”

Section: Resultsmentioning

confidence: 91%

“…The continuous consumption of BZD indeed has a strong potential for habituation that results in undesirable unintended physical/psychological dependency in addition to well intended and acceptable therapeutic dependency. It is a common knowledge that nowadays 1/3 of women over 50, 1/5 of men over 50, [6]- [9] and 14% of the non-institutionalized over 60 population uses medically prescribed BZDs on an uninterrupted basis [4] [10]. Yet, more the population grows in age, the more side effects can be observed: falls with or without fractures, memory impairment, confusion, attention deficits that may lead to accidental injuries to patients, etc., [8] [11].…”

Section: Introductionmentioning

confidence: 99%

Original and Simple Protocol for Withdrawal of Benzodiazepines to Achieve Sustained Remission

Granato¹,

Vinekar²,

Audrey³

et al. 2016

OJPsych

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Benzodiazepines are psychotropic medications for effective management of anxiety. However, after over 50 years of unrestrained prescription use, prescribers realize the severity of side effects in select patients. The most challenging of these side effects is the emergence of a physiological dependence that explains virtual impossibility of successful withdrawal that can ensure sustained abstinence. We propose a method for successful withdrawal using substitution and innovative downward tapering of diazepam oral solution for all benzodiazepines to attain sustained remission. Our protocol reported here allowed not only successful withdrawal for all of 20 patients included in this pilot study but also helped in totally weaning them off of benzodiazepines demonstrating absence of relapse even 2 years after the total discontinuance.

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Benzodiazepine dependence: Focus on withdrawal syndrome

Cited by 56 publications

References 24 publications

Acupuncture Attenuates Anxiety‐Like Behavior by Normalizing Amygdaloid Catecholamines during Ethanol Withdrawal in Rats

Acupuncture Attenuates Anxiety‐Like Behavior by Normalizing Amygdaloid Catecholamines during Ethanol Withdrawal in Rats

Assessment of dependence and anxiety among benzodiazepine users in a provincial municipality in Rio Grande do Sul, Brazil

Original and Simple Protocol for Withdrawal of Benzodiazepines to Achieve Sustained Remission

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