Addiction of High Dose of Benzodiazepine: Verona Detox Approach With Flumazenil

Casari, Rebecca; Metastasio, Antonio; Zamboni, Lorenzo; Biasioli, Martino; Campagnari, Simone; Lugoboni, Fabio

doi:10.3389/fpsyt.2022.857376

Cited by 5 publications

(8 citation statements)

References 27 publications

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“…Rossi University Hospital in Verona. The data were collected from hospitalizations carried out between January 2015 and February 2020 and refer to a total of 74 patients, of which 38 were males and 36 were females, that were being treated for detoxification from high doses of Zolpidem with “Verona Detox Approach With Flumazenil” ( 30 , 31 ).…”

Section: Methodsmentioning

confidence: 99%

Case Report: High doses of Zolpidem and QT interval lengthening: Is there a relationship? A case series

et al. 2022

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Zolpidem is indicated in cases of severe insomnia in adults and, as for BDZs, its assumption should be limited to short periods under close medical supervision. Since several drugs cause corrected QT interval (QTc) elongation, the authors investigated whether high daily doses of Zolpidem could cause QTc elongation. The study was conducted in the Addiction Medicine Unit of the G.B. Rossi University Hospital in Verona. The data were collected from hospitalizations carried out between January 2015 and February 2020 and refer to a total of 74 patients, 38 males and 36 females, who were treated for detoxification from high doses of Zolpidem with the “Verona Detox Approach With Flumazenil.” One patient out of 74 had QTc elongation (479 ms). The patient was male and took a daily dose of 50 mg of Zolpidem; he did not take concomitant therapies that could cause QTc lengthening. He had no electrolyte alterations, no contemporary or previous intake of barbiturates, heroin, cocaine, THC, alcohol, NMDA or nicotine which could cause an elongation of the QTc interval. The present study highlights the low risk of QTc elongation due to high dosages of Zolpidem; however, if, on one hand, we can affirm that Zolpidem is a safe drug, on the other, the widespread use of high dosages of this drug for prolonged periods of time is problematic and worrying.

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Section: Methodsmentioning

confidence: 99%

Case Report: High doses of Zolpidem and QT interval lengthening: Is there a relationship? A case series

et al. 2022

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“…Due to high risk for epileptic seizures during the withdrawal, carbamazepine may be preventively given in dose of 800 mg per day [15]. The second protocol includes a short half-life BDZ agent replacement with a long half-life whose dose is then gradually reduced [15,50]. Diazepam is most commonly used in this protocol, but in the treatment of alprazolam withdrawal symptoms, clonazepam is more effective [15].…”

Section: Benzodiazepines -Induced Deliriummentioning

confidence: 99%

GABAergic Psychoactive Substance-Induced Delirium: Narrative Literature Review

Tomašić

Petrović

2023

Arch. Psychiatry Res.

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Psychoactive substance-induced delirium is delirium which occurs during or immediate after psychoactive substance intoxication, withdrawal or during the use of specific psychoactive substance. It is characterized by sudden onset of disturbed consciousness, disorientation, hallucinations, changed psychomotor activity, insomnia, acute memory impairment, violent, and bizarre behaviour. The most commonly abused psychoactive substances which may induce delirium are those acting on the major inhibitory neurotransmitter gamma aminobutyric acid (alcohol, anxiolytics, sedatives, hypnotics, and gammahydroxybutyrate- GHB. Psychoactive substance-induced delirium may have hyperactive, hypoactive or mixed clinical presentation. Treatment of delirium induced by psychoactive substances is carried out with antipsychotics, anxiolytics, and sedatives, but each of the listed abused psychoactive substances has its own treatment peculiarities. This narrative literature review describes the epidemiology, pathophysiology, clinical presentation, and treatment of delirium induced by intoxication and withdrawal from GABAergic psychoactive substances. The paper summarizes well-known knowledge with the latest research in psychoactive substances-induced delirium.

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“…In this study, all patients had been treated using the Verona Detox Approach with Flumazenil, a slow subcutaneous infusion of flumazenil (1 mg/die) for 7 days 44 .…”

Section: Introductionmentioning

confidence: 99%

High-dose benzodiazepine use and QTc interval prolongation, a latent class analysis study

Zamboni,

Portoghese,

Casari

et al. 2024

Sci Rep

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Benzodiazepine (BDZ) addiction is a widespread and multifaceted phenomenon. For many patients, especially females, the concomitant use of other drugs also increases their risk of QTc prolongation, possibly leading to complications such as seizures and even sudden death. However, the relationship between BDZ use and QTc prolongation is currently unclear. The present study aims to examine patterns of polysubstance use among a sample of Italian adults with BDZ dependence in relation with their QTc prolongation risk. We used Latent Class Analysis (LCA) on data collected from 251 inpatients of the Addiction Medicine Unit in Verona to group patients into three classes according to their substance use and their QTc prolongation risk. Results showed no significant relationship between QTc prolongation and BDZ use in any of the classes considered. We conclude that BDZs, even if used long-term and at high dosages, can be considered safe in terms of cardiovascular complications for patients.

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Addiction of High Dose of Benzodiazepine: Verona Detox Approach With Flumazenil

Cited by 5 publications

References 27 publications

Case Report: High doses of Zolpidem and QT interval lengthening: Is there a relationship? A case series

Case Report: High doses of Zolpidem and QT interval lengthening: Is there a relationship? A case series

GABAergic Psychoactive Substance-Induced Delirium: Narrative Literature Review

High-dose benzodiazepine use and QTc interval prolongation, a latent class analysis study

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