Strategies for the treatment of acute benzodiazepine toxicity in a clinical setting: the role of antidotes

Zamani, Nasim; Hassanian‐Moghaddam, Hossein; Zamani, Naghmeh

doi:10.1080/17425255.2022.2105692

Cited by 6 publications

(4 citation statements)

References 86 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Instead, we favored definitive airway management to mitigate the risks of benzodiazepine withdrawal or seizures. 27 This strategy might have contributed to the increased rates of ICU admission and endotracheal intubation observed in our study. Specifically, 18.6% of patients with substance abuse were admitted to the ICU and 11.7% required endotracheal intubation.…”

Section: Discussionmentioning

confidence: 82%

Predictive factors for severe outcomes in substance abuse-related emergency visits: A 5-year retrospective analysis at a medical center in Taiwan

Hsieh,

Hsu,

Yang

2023

Journal of the Chinese Medical Association

View full text Add to dashboard Cite

Background: Substance abuse is a considerable medical issue worldwide, yet current surveillance systems in Taiwan offer limited insights into the clinical characteristics and outcomes of substance abuse patients. This study aimed to delineate the epidemiology of emergency department visits related to substance abuse at a hospital in Taiwan and to identify factors predictive of severe complications or mortality. Methods: A retrospective analysis was conducted on substance abuse-related emergency department visits at a medical center in Taiwan between 2009 and 2013. Eligible participants were individuals aged 20 or older who had confirmed substance abuse through urinalysis. Variables such as patient demographics, substances abused, clinical characteristics, and outcomes were collected. Severe outcomes were defined as admission to the intensive care unit, requirement for endotracheal intubation, or in-hospital death. Logistic regression models were employed to identify factors contributing to severe outcomes. Results: The cohort consisted of 623 patients, of whom 64.0% were female and 67.1% were aged between 20 and 49 years. Benzodiazepines were detected in 75.3% of patients, while z-drugs (specifically zopiclone, zolpidem, or zaleplon) were found in 27.8%. Depressants, stimulants, and hallucinogens were present in 14.9%, 10.6%, and 0.6% of the cases, respectively. Of the patient, 121 (19.4%) experienced severe outcomes, including 116 (18.6%) intensive care unit admissions, 73 (11.7%) intubations, and 11 (1.8%) in-hospital deaths. Multivariable logistic regression analysis revealed multiple predictors of severe outcomes, such as emergency department triage level, aspiration pneumonia, leukocytosis, abnormal hepatic function, abnormal renal function, hypernatremia, and hypocalcemia. Conclusion: In Taiwan, benzodiazepines emerged as the most prevalent substance of abuse among emergency department visitors, and a significant proportion of these patients experienced severe outcomes. Continuous monitoring of severe outcome predictors is essential for enhanced understanding and management.

show abstract

Section: Discussionmentioning

confidence: 82%

Predictive factors for severe outcomes in substance abuse-related emergency visits: A 5-year retrospective analysis at a medical center in Taiwan

Hsieh,

Hsu,

Yang

2023

Journal of the Chinese Medical Association

View full text Add to dashboard Cite

show abstract

“…Puede producir un desorden en los movimientos musculares voluntarios (ataxia), dificultad para la articulación de las palabras (disartria) y una característica oscilación espasmódica del globo ocular (nistagmo). La depresión respiratoria aparece en intoxicaciones graves, pudiendo complicarse con broncoaspiración (23).…”

Section: Cuadro Clínicounclassified

Intento autolítico farmacológico. Diagnóstico y tratamiento. Revisión bibliográfica.

Jara-Chacón,

Salgado-Ordoñez

2023

MQRInvestigar

View full text Add to dashboard Cite

Introducción: el suicido es un problema de salud mundial de rápido crecimiento, según la Organización Mundial de la Salud, cada año se suicidan cerca de 700 000 personas siendo la cuarta causa más común de muerte entre los jóvenes de 17 a 29 años. Las manifestaciones clínicas más frecuentes son neurológicas, las complicaciones suelen aparecer sobre el aparato respiratorio, digestivo y van desde la broncoaspiración hasta falla renal y hepática. Objetivo General: describir el diagnóstico y tratamiento del intento autolítico farmacológico. Metodología: se realizó una revisión bibliográfica de tipo narrativo, no experimental, en donde se realizó́ una estrategia de búsqueda de articular relación con el tema de investigación en bases de datos, además, se consideraron ensayos clínicos controlados aleatorizados que evalúen el intento autolítico farmacológico, diagnóstico y tratamiento. Resultados: se evidencio que el paracetamol fue el medicamento más utilizado por su fácil accesibilidad seguido de fenobarbital y diazepam en un 61,5%, y antihistamínicos y antiinflamatorios en un 11,5%. Los síntomas predominantes en intoxicación medicamentosas fueron de tipo neurológico. Conclusión: es importante reconocer el carácter bidimensional del problema, aspectos psicológico y toxicológico, con el propósito de manejar estos pacientes adecuadamente y reducir el riesgo de recidiva.

show abstract

“…Current treatment modalities for BZD dependence predominantly encompass pharmacotherapy and psychological interventions 10,11 . However, these approaches have limitations and may not be universally suitable for all patients.…”

Section: Introductionmentioning

confidence: 99%

“…Current treatment modalities for BZD dependence predominantly encompass pharmacotherapy and psychological interventions. 10 , 11 However, these approaches have limitations and may not be universally suitable for all patients. Conventional treatments, although partially effective, often inadequately address the intricate interplay of these symptoms.…”

Section: Introductionmentioning

confidence: 99%

Effective alleviation of depressive and anxious symptoms and sleep disorders in benzodiazepine‐dependent patients through repetitive transcranial magnetic stimulation

Chen,

Zhang

et al. 2024

Addiction Biology

View full text Add to dashboard Cite

Benzodiazepine (BZD) dependence poses a significant challenge in mental health, prompting the exploration of treatments like repetitive transcranial magnetic stimulation (rTMS). This research aims to assess the impact of rTMS on alleviating symptoms of BZD dependence. A randomized control trial was employed to study 40 BZD‐dependent inpatients. Their symptoms were quantified using the Hamilton Anxiety Rating Scale (HAMA), Montgomery–Åsberg Depression Rating Scale (MADRS) and Pittsburgh Sleep Quality Index (PSQI). Participants were divided into a conventional treatment group (daily diazepam with gradual tapering) with supportive psychotherapy and another group receiving the same treatment supplemented with rTMS (five weekly sessions for 2 weeks). Significant improvements were observed in both groups over baseline in MADRS, HAMA and PSQI scores at the 2nd, 4th, 8th and 12th week assessments (p < 0.05). The group receiving rTMS in addition to conventional treatment exhibited superior improvements in all measures at the 8th and 12th weeks. The addition of rTMS to conventional treatment methods for BZD dependence significantly betters the recovery in terms of depression, anxiety and sleep quality, highlighting the role of rTMS as an effective adjunct therapy.

show abstract

Strategies for the treatment of acute benzodiazepine toxicity in a clinical setting: the role of antidotes

Cited by 6 publications

References 86 publications

Predictive factors for severe outcomes in substance abuse-related emergency visits: A 5-year retrospective analysis at a medical center in Taiwan

Predictive factors for severe outcomes in substance abuse-related emergency visits: A 5-year retrospective analysis at a medical center in Taiwan

Intento autolítico farmacológico. Diagnóstico y tratamiento. Revisión bibliográfica.

Effective alleviation of depressive and anxious symptoms and sleep disorders in benzodiazepine‐dependent patients through repetitive transcranial magnetic stimulation

Contact Info

Product

Resources

About