1/163. A case of gamma-hydroxybutyric acid withdrawal syndrome during alcohol addiction treatment: utility of diazepam administration.Gamma-hydroxybutyric acid (GHB) is an emerging drug for alcoholism therapy. We present a case of GHB withdrawal syndrome secondary to GHB addiction during alcoholism treatment. A complete disappearance of drug withdrawal syndrome was achieved with oral diazepam and the symptoms resolved without sequelae. GHB has been used for alcoholism therapy for only a few years now, but the trend is increasing, and other cases similar to this one are foreseeable. This risk could be higher in some countries in which GHB use is increasing not for alcoholism therapy, but for its euphoric and anabolic effects. The present experience indicates that administration of benzodiazepines would seem to be sufficient to achieve total regression of the withdrawal syndrome in a short time, at least if recognized early.- - - - - - - - - - ranking = 1keywords = addiction (Clic here for more details about this article) |
2/163. methadone withdrawal when starting an antiretroviral regimen including nevirapine.Antiretrovirals from three drug classes, nucleoside analogs, nonnucleoside analogs, and protease inhibitors, can be combined to achieve viral suppression. The nonnucleoside analog nevirapine is an inducer of cytochrome P450 3A4 liver metabolism and has interactions with protease inhibitors and oral contraceptives. methadone has two roles in human immunodeficiency viral infection: pain management and treatment of opioid abuse. A drug-drug interaction may result in decreased methadone blood levels when administered with nevirapine. A patient experienced methadone withdrawal symptoms when combining these agents.- - - - - - - - - - ranking = 0.0035367488145583keywords = abuse (Clic here for more details about this article) |
3/163. Opioid withdrawal during risperidone treatment.A small but significant percentage of opioid-dependent patients will require neuroleptic treatment. Several classes of drugs have been shown to affect opioid metabolism. Two patients who were hospitalized with a diagnosis of opioid dependence received concomitant treatment with opioids and risperidone. After receiving risperidone for several days, both patients exhibited symptoms of opioid withdrawal despite having no change in their opioid doses. These withdrawal symptoms resolved soon after risperidone was discontinued. This finding suggests the possibility that risperidone may precipitate opioid withdrawal in opioid-dependent patients.- - - - - - - - - - ranking = 1.3560069546051keywords = dependence (Clic here for more details about this article) |
4/163. nevirapine induced opiate withdrawal among injection drug users with hiv infection receiving methadone.BACKGROUND: Pharmacokinetic interactions complicate and potentially compromise the use of antiretroviral and other hiv therapeutic agents in patients with hiv disease. This may be particularly so among those receiving treatment for substance abuse. OBJECTIVE: We describe seven cases of opiate withdrawal among patients receiving chronic methadone maintenance therapy following initiation of therapy with the non-nucleoside reverse transcriptase inhibitor, nevirapine. DESIGN: Retrospective chart review. RESULTS: In all seven patients, due to the lack of prior information regarding a significant pharmacokinetic interaction between these agents, the possibility of opiate withdrawal was not anticipated. Three patients, for whom methadone levels were available at the time of development of opiate withdrawal symptoms, had subtherapeutic methadone levels. In each case, a marked escalation in methadone dose was required to counteract the development of withdrawal symptoms and allow continuation of antiretroviral therapy. Three patients continued nevirapine with methadone administered at an increased dose; however, four chose to discontinue nevirapine. CONCLUSION: To maximize hiv therapeutic benefit among opiate users, information is needed about pharmacokinetic interactions between antiretrovirals and therapies for substance abuse.- - - - - - - - - - ranking = 0.0070734976291166keywords = abuse (Clic here for more details about this article) |
5/163. nicotine dependence and withdrawal in an oncology setting: a risk factor for psychiatric comorbidity and treatment non-adherence.Highly nicotine dependent oncology patients are at high risk for psychiatric morbidity when they enter the medical care setting where smoking restrictions apply. nicotine withdrawal symptoms exacerbate cancer-related distress as well as common physical side effects of cancer treatment. This case report illustrates the management of a patient whose ongoing treatment for bladder cancer was jeopardized as a result of nicotine dependence and withdrawal. Several associated complications are described, the most serious of which were his acute anxiety and non-adherence to medical recommendations. A short-term management approach that included anxiolytics and nicotine replacement was effectively used to reduce this patient's excessive anxiety and thus facilitate compliance with stressful treatments. The severity of complications that can result from untreated nicotine dependence and withdrawal underscores the importance of assessing and monitoring smoking status in every patient. Greater staff awareness of the clinical practice guidelines regarding the diagnosis and treatment of nicotine dependence will likely result in improved patient care and compliance.- - - - - - - - - - ranking = 9.4920486822355keywords = dependence (Clic here for more details about this article) |
6/163. Emergency therapeutical approach simulating ultrarapid opioid detoxification in methadone withdrawal precipitated by erroneous administration of naltrexone.We report the case of a 30-year-old male, heroin dependent, receiving methadone treatment, who, while staying at home, ingested 50 mg of naltrexone. He immediately developed serious withdrawal symptoms and was admitted to the hospital. In the emergency department the drugs given to counteract the agitation were ineffective, and the patient developed respiratory distress. Anaesthesia with propofol was then started and the patient was intubated, ventilated and hospitalized in the intensive care unit. He was then sedated for 48 hours due to persistent withdrawal signs. When medically stable the patient was transferred to the medical ward where daily treatment with naltrexone and psychological support where started. After 4 days the patient was discharged. Afterwards he did not attend his scheduled outpatient follow-up visits. Treatment with propofol is effective in the case of a patient with a serious withdrawal syndrome secondary to naltrexone overdose during methadone therapy. Despite the actual possibility of getting through the withdrawal symptoms the patient failed to return for follow-up visits, which might be related to a lack of motivation.- - - - - - - - - - ranking = 0.11216358552608keywords = heroin (Clic here for more details about this article) |
7/163. Medical treatment of the adolescent drug abuser. An opportunity for rehabilitative intervention.Illnesses related to both the pharmacologic properties of abused substances and their methods of administration often bring the teenager to medical attention and may provide sufficient motivation for the adolescent to seek help beyond the acute problem. Successful treatment of an overdose reaction, an abstinence syndrome, or any other medical complication of drug abuse may give the physician a unique opportunity to begine further evalution for future care.- - - - - - - - - - ranking = 0.02122049288735keywords = abuse (Clic here for more details about this article) |
8/163. Phenomenology of gasoline intoxication and withdrawal symptoms among adolescents in india: a case series.Inhalant withdrawal symptoms have previously been described but not well documented. This case-series describes the sociodemographic and clinical characteristics of nine children and adolescents with gasoline abuse. gasoline inhalation was the drug of choice in our patients. The mean age was 13.6 years and all the subjects belonged to low socioeconomic status. Most of the subjects used daily and all subjects reported alcohol abuse in the father. All subjects reported a syndrome of intoxication as described in previous reports. All subjects also reported a withdrawal syndrome including irritability, psychomotor retardation, anhedonia, dry mouth, sleep disturbances, craving, and increased lacrimation.- - - - - - - - - - ranking = 0.0070734976291166keywords = abuse (Clic here for more details about this article) |
9/163. Substance abuse and emergency psychiatry.Given the high rates of comorbidity, patients commonly present with multiple diagnoses to PESs or crisis services. Clinicians must be well versed in the evaluation, differential diagnosis, and treatment of patients with substance-abuse disorders or other axis I, II, or III conditions if they are to provide state-of-the-art treatment of patients in need of emergency care.- - - - - - - - - - ranking = 0.017683744072791keywords = abuse (Clic here for more details about this article) |
10/163. A therapeutic use of the methadone fluvoxamine drug interaction.BACKGROUND: methadone has been effectively used in the treatment of opiate dependence. Adequate dose and blood level have correlated with success in treatment. A number of factors including the regular use of alcohol, medications, and urinary pH can influence blood level and thereby effectiveness. fluvoxamine has been shown to increase methadone blood levels. methods: Single case report. RESULTS: A patient unable to maintain an effective methadone blood level despite a dose of 200 mg per day was administered fluvoxamine with subsequent increase in her methadone blood level and reduction of opiate withdrawal symptoms. CONCLUSIONS: In patients unable to maintain an effective methadone blood level throughout the dosing interval, fluvoxamine can help increase the methadone blood level and alleviate opiate withdrawal symptoms.- - - - - - - - - - ranking = 1.3560069546051keywords = dependence (Clic here for more details about this article) |
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