Intravenous flumazenil infusion to treat benzodiazepine dependence should be performed in the inpatient clinical setting for high risk of seizure

Lugoboni, Fabio; Faccini, Marco; Quaglio, GL; Albiero, A.; Casari, Rebecca; Pajusco, Benedetta

doi:10.1177/0269881110393050

Cited by 18 publications

(14 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Cyamemazine, an anxiolytic antipsychotic agent, has shown promise as a treatment for the BZD withdrawal syndrome (32). The use of a slow infusion of the BZD antagonist flumazenil has been shown to be feasible (33), but carries a high risk of seizures (34). No clearly effective pharmacotherapy for the treatment of BZD use disorder has been identified (24).…”

Section: Introductionmentioning

confidence: 99%

Pilot trial of gabapentin for the treatment of benzodiazepine abuse or dependence in methadone maintenance patients

Mariani

Malcolm

Mamczur

et al. 2016

The American Journal of Drug and Alcohol Abuse

View full text Add to dashboard Cite

Background Benzodiazepine (BZD) use disorders are a common clinical problem among methadone maintenance treatment patients and have adverse effects on clinical outcomes. Objectives To evaluate gabapentin for the outpatient treatment of BZD abuse or dependence in methadone maintenance patients. Methods Participants (n=19) using BZDs at least 4 days per week were enrolled into an eight-week randomized double-blind placebo-controlled outpatient pilot trial. All participants received a manual-guided supportive psychotherapy aimed to promote abstinence. Study medication was titrated over a two-week period to a maximum dose of gabapentin 1200 mg or placebo three times a day. BZD use was assessed using urine toxicology confirmed self-report. BZDs were not provided as part of study participation; participants were provided guidance to gradually reduce BZD intake. Results Sixteen participants had post-randomization data for analysis. Retention at week eight was 50%. The mean dose of gabapentin achieved by titration was 2666 mg/day (SD=±1446). There were no significant between group differences on BZD use outcomes (amount BZD per day (Mann-Whitney U = 27, p = .745), abstinent days per week (U = 28, p = .811)) and CIWA-BZD scale (U = 29.0, p = .913). One participant in the gabapentin group discontinued study medication because of peripheral edema. Two participants in the placebo group requested admission for inpatient detoxification treatment. Conclusion Gabapentin was not found to differ from placebo, although the small sample recruited for this trial may have limited the ability to detect a difference.

show abstract

Section: Introductionmentioning

confidence: 99%

Pilot trial of gabapentin for the treatment of benzodiazepine abuse or dependence in methadone maintenance patients

Mariani

Malcolm

Mamczur

et al. 2016

The American Journal of Drug and Alcohol Abuse

View full text Add to dashboard Cite

show abstract

“…19 Although relatively uncommon, seizures can occur with low-dose flumazenil infusion and so it should only be considered in a specialised unit. 20 …”

Section: Pharmacotherapymentioning

confidence: 99%

Management of benzodiazepine misuse and dependence

Brett¹,

Murnion²

2015

Aust Prescr

180

121

View full text Add to dashboard Cite

“…Unfortunately, the use of such a procedure is not widespread, although our group has been applying it successfully on highdose benzodiazepine users for about 10 years (Faccini et al, 2012;Lugoboni et al, 2011b;Quaglio et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Slow subcutaneous infusion of flumazenil for the treatment of long-term, high-dose benzodiazepine users: a review of 214 cases

et al. 2016

View full text Add to dashboard Cite

Despite the first reports concerning benzodiazepine dependence being published in the early 1960s literature, the risk of benzodiazepine addiction is still greatly debated. The severe discomfort and life threatening complications usually experienced by long-term benzodiazepine users who suddenly interrupt benzodiazepine intake have led to the development of several detoxification protocols. A successful strategy used by our Addiction Unit is abrupt benzodiazepine cessation by administering flumazenil slow subcutaneous infusion (FLU-SSI) with an elastomeric pump. Although some studies proved the efficacy of flumazenil infusion more than 20 years ago, only a few centres in the world offer this method to their patients. This paper reports the data related to 214 subjects addicted to high doses of benzodiazepine and treated with the FLU-SSI method between 2012 and 2014. This technique is less invasive and requires less nursing intervention than intravenous infusion. Our data support FLU-SSI as a possible efficient strategy for the treatment of patients with long-term, high-dose benzodiazepine addiction, and could become a routine therapy as long as the necessary further studies on dose, duration of infusion and safety issues are carried out.

show abstract

Intravenous flumazenil infusion to treat benzodiazepine dependence should be performed in the inpatient clinical setting for high risk of seizure

Cited by 18 publications

References 6 publications

Pilot trial of gabapentin for the treatment of benzodiazepine abuse or dependence in methadone maintenance patients

Pilot trial of gabapentin for the treatment of benzodiazepine abuse or dependence in methadone maintenance patients

Management of benzodiazepine misuse and dependence

Slow subcutaneous infusion of flumazenil for the treatment of long-term, high-dose benzodiazepine users: a review of 214 cases

Contact Info

Product

Resources

About