Objectives To evaluate the efficacy of oral clonazepam versus oral lorazepam following initial parenteral benzodiazepine administration to control methamphetamine-induced agitation in children. Methods In a single-center clinical trial, intravenous diazepam (0.2 mg/Kg) was initially administered to all methamphetamine-poisoned pediatric patients to control their agitation, followed by a single dose of oral clonazepam (0.05 mg/Kg; n = 15) or oral lorazepam (0.05 mg/Kg; n = 15) to prevent relapse of toxicity. Results The median age [IQR] (range) was 15 [10, 36] (6-144) months. The source of poisoning was methamphetamine exposure from oral ingestion in 23 (76.7%) and passive inhalation in 7 (23.3%) patients. The most common symptoms/signs were agitation (29; 96.7%), mydriatic pupils (26; 86.7%), and tachycardia (20; 66.6%). Two in each group (13.3%) needed re-administration of intravenous diazepam due to persistent agitation. There was no report of benzodiazepine complications in either group. Conclusions Clonazepam and lorazepam treatment was equally effective at similar doses. However, considering the higher potency of clonazepam, it seems that lorazepam is the safer benzodiazepine for oral maintenance treatment of methamphetamine-induced agitation in children and can be used with minimal complications. Trial registration IRCT20180610040036N2, April 18th, 2020. Retrospectively registered.
Background: To evaluate the efficacy of oral clonazepam versus oral lorazepam following initial parenteral benzodiazepine administration to control methamphetamine-induced agitation in children. Methods: In a single-center clinical trial, intravenous diazepam (0.2 mg/Kg) was initially administered to all methamphetamine-poisoned pediatric patients to control their agitation, followed by a single dose of oral clonazepam (0.05 mg/Kg; n=15) or oral lorazepam (0.05 mg/Kg; n=15) to prevent relapse of toxicity. Results: The median age [IQR] (range) was 15 [10, 36] (6-144) months. The source of poisoning was methamphetamine exposure from oral ingestion in 23 (76.7%) and passive inhalation in 7 (23.3%) patients. The most common symptoms/signs were agitation (29; 96.7%), mydriatic pupils (26; 86.7%), and tachycardia (20; 66.6%). Two in each group (13.3%) needed re-administration of intravenous diazepam due to persistent agitation. There was no report of benzodiazepine complications in either group.Conclusions: Although both benzodiazepines were effective, considering the similar administered doses of oral clonazepam and lorazepam as well as the higher potency of clonazepam, it seems that lorazepam is a better suited oral benzodiazepine for the maintenance treatment of methamphetamine-induced agitation in children and can be used with minimal complications.Trial registration: IRCT20180610040036N2, April 18th, 2020. Retrospectively registered
Background: To evaluate the efficacy of oral clonazepam versus oral lorazepam following initial parenteral benzodiazepine administration to control methamphetamine-induced agitation in children.Methods: In a single-center clinical trial, intravenous diazepam (0.2 mg/Kg) was initially administered to all methamphetamine-poisoned pediatric patients to control their agitation, followed by a single dose of oral clonazepam (0.05 mg/Kg; n = 15) or oral lorazepam (0.05 mg/Kg; n = 15) to prevent relapse of toxicity.Results: The median age [IQR] (range) was 15 [10, 36] (6-144) months. The source of poisoning was methamphetamine exposure from oral ingestion in 23 (76.7%) and passive inhalation in 7 (23.3%) patients. The most common symptoms/signs were agitation (23; 96.7%), mydriatic pupils (26; 86.7%), and tachycardia (20; 66.6%). Four patients (13.3%) needed re-administration of IV diazepam due to persistent agitation. There was no report of benzodiazepine complications in either group.Conclusions: Although both benzodiazepines were effective, considering the similar administered doses of oral clonazepam and lorazepam as well as the higher potency of clonazepam, it seems that lorazepam is a better suited oral benzodiazepine for the maintenance treatment of methamphetamine-induced agitation in children and can be used with minimal complications.Trial registration: IRCT20180610040036N2, April 18th 2020. Retrospectively registered
Background: To evaluate the efficacy of oral clonazepam versus oral lorazepam following initial parenteral benzodiazepine administration to control methamphetamine-induced agitation in children. Methods: In a single-center clinical trial, intravenous diazepam (0.2 mg/Kg) was initially administered to all methamphetamine-poisoned pediatric patients to control their agitation, followed by a single dose of oral clonazepam (0.05 mg/Kg; n=15) or oral lorazepam (0.05 mg/Kg; n=15) to prevent relapse of toxicity. Results: The median age [IQR] (range) was 15 [10, 36] (6-144) months. The source of poisoning was methamphetamine exposure from oral ingestion in 23 (76.7%) and passive inhalation in 7 (23.3%) patients. The most common symptoms/signs were agitation (23; 96.7%), mydriatic pupils (26; 86.7%), and tachycardia (20; 66.6%). Four patients (13.3%) needed re-administration of IV diazepam due to persistent agitation. There was no report of benzodiazepine complications in either group.Conclusions: Although both benzodiazepines were effective, considering the similar administered doses of oral clonazepam and lorazepam as well as the higher potency of clonazepam, it seems that lorazepam is a better suited oral benzodiazepine for the maintenance treatment of methamphetamine-induced agitation in children and can be used with minimal complications.Trial registration: IRCT20180610040036N2, April 18th 2020. Retrospectively registered
Objectives: To evaluate the efficacy of oral clonazepam versus oral lorazepam following initial parenteral benzodiazepine administration to control methamphetamine-induced agitation in children. Methods: In a single-center clinical trial, intravenous diazepam (0.2 mg/Kg) was initially administered to all methamphetamine-poisoned pediatric patients to control their agitation, followed by a single dose of oral clonazepam (0.05 mg/Kg; n=15) or oral lorazepam (0.05 mg/Kg; n=15) to prevent relapse of toxicity. Results: The median age [IQR] (range) was 15 [ 10, 36] (6-144) months. The source of poisoning was methamphetamine exposure from oral ingestion in 23 (76.7%) and passive inhalation in 7 (23.3%) patients. The most common symptoms/signs were agitation (29; 96.7%), mydriatic pupils (26; 86.7%), and tachycardia (20; 66.6%). Two in each group (13.3%) needed re-administration of intravenous diazepam due to persistent agitation. There was no report of benzodiazepine complications in either group. Conclusions: Clonazepam and lorazepam treatment was equally effective at similar doses. However, considering the higher potency of clonazepam, it seems that lorazepam is the safer benzodiazepine for oral maintenance treatment of methamphetamine-induced agitation in children and can be used with minimal complications. Trial registration: IRCT20180610040036N2, April 18 th , 2020. Retrospectively registered
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