The Effect of Methylphenidate on Reed Scaling in Benzodiazepine Poisoning: A Prospective Trial

Abstract

Background: Benzodiazepine is one of the most important causes of substance abuse and intoxication throughout the world and Iran. Objective: The aim of our study is to determine the role of stimulants in reversing CNS level in acute Benzodiazepine poisoning patients who were hospitalized at referral poison center. Methods: This was a randomized double-blind placebo-controlled trial study on 32 cases with pure acute Benzodiazepine poisoning from March 2016 to February 2017. Diagnosis of pure acute poisoning was based on history, and laboratory confirmation. We gathered the demographics, clinical data, laboratory data, hospitalization and outcome. Participants were randomized into two groups: Methylphenidate Group (MPH) and Placebo Group (PBO). Results: The randomized sample consisted of 32 participants who were predominately female (83%). The majority of the PBO group and the MPH group reported improvement in their consciousness with a significant difference between the two groups (p = .005). Paired sample t-test analyses on Reed Scale data revealed an increase in the probability of improvement during the trial for the MPH group compared to the PBO group. Furthermore, the HCo3 (bicarbonate) level has a significant p-value with respect to age groups (p = .02). None of our cases required either the ICU facility or intubation. Conclusion: Our study provided the MPH superiority over PBO in reversing CNS symptoms in loss of consciousness in acute BZD poisoned patients. Thus, this trial provides concrete evidence that improvement in consciousness levels (Reed Scale rated) among those patients receiving MPH was associated with a methylphenidate use.

Intento autolítico farmacológico. Diagnóstico y tratamiento. Revisión bibliográfica.

“…El uso de flumazenil se asocia con efectos adversos de convulsiones, en especial en casos de pacientes con dependencia de benzodiacepinas. En conclusión, los autores indican que el metilfenidato mostró superioridad para revertir síntomas de pérdida de conciencia comparados con el grupo de placebo (36).…”

“…En cuanto al diagnóstico según la bibliografía utilizada en el presente trabajo el diagnóstico se basó en la historia clínica, examen físico, pruebas de laboratorio, este estudio concuerda, con los hallazgos de Lantifi 202 et al (36), el diagnóstico se basó en la historia clínica, examen físico, pruebas de laboratorio y residuos de benzodiacepinas en prueba de orina demostrando en las evaluaciones iniciales de paraclínicos se observa un aumento en el bicarbonato en edades de 36 y 50 años, además los niveles de PCO2 aumentaron en pacientes de 15 a 25 años y de 36 a 50 años.…”

Acute Poisoning of Benzodiazepines Among Patients Admitted to Loghman Hakim Hospital

“…Respiratory depression is uncommon with benzodiazepines alone, but respiratory depression can be noted if taken with concomitant medications such as ethanol or other drugs or substances. Patients with severe intoxication appear in a state of anesthesia or coma [1,3,[6][7][8].…”

Manejo Terapêutico Por Abuso De Drogas Benzodiazepínicas

“…Já o estudo deLatifi-Pour et al (2020) foi conduzido no Centro de Intoxicação do Hospital Hakim com pacientes hospitalizados na ala toxicológica e unidades de terapia intensiva de toxicologia médica, e buscou determinar o papel dos estimulantes na reversão do SNC em pacientes com intoxicação. Nesse ensaio clínico, o envenenamento por benzodiazepínicos é tido como nível significativamente maior de depressão no SNC, com incidência de coma.…”