Characterization of benzodiazepine withdrawal in high- and low-dose dependent psychiatric inpatients. 1987

C Schmauss, and S Apelt, and H M Emrich
Max Planck Institute for Psychiatry, Munich, FRG.

Fourteen patients with high- (n = 7) and low-dose (n = 7) benzodiazepine (BDZ) dependency presented predominantly with anxious and depressive neurotic symptoms which caused long-term BDZ medication. Their BDZ dependency was characterized by giving preference to the abuse of benzodiazepines with long elimination half-life. Significant enlargement of CSF spaces was only found in high-dose dependent patients. Withdrawal after long-term BDZ medication revealed no differences between high- and low-dose BDZ dependency with respect to onset of withdrawal reaction and the correlation between onset of withdrawal and peak fall of BDZ serum level. The peak of withdrawal was reached 3-4 days later in high-dose BDZ dependent patients compared with those with a low-dose dependency. The peak withdrawal in high-dose dependent patients appeared when the serum BDZ metabolite nordiazepam dropped significantly. No such concomitant appearance of peak withdrawal and drop of serum nordiazepam level could be found in low-dose dependent patients. Specificity and intensity of BDZ withdrawal symptoms were the same for those dependent upon high doses of BDZs and those dependent upon low doses, but a protracted withdrawal was only observed in low-dose BDZ-dependent patients. During the withdrawal period psychopathometric measurements consistently revealed parallel changes in the scores for physical withdrawal symptoms, anxiety and depression. It is not clear whether anxiety and depression are "typical" BDZ withdrawal reactions or represent a "reactivated" state of the psychopathological disturbance which lead to the BDZ dependency. Possible implications for the therapeutical management of BDZ-dependent patients are discussed.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011618 Psychotic Disorders Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994) Psychoses,Psychosis, Brief Reactive,Schizoaffective Disorder,Schizophreniform Disorders,Psychosis,Brief Reactive Psychoses,Brief Reactive Psychosis,Disorder, Psychotic,Disorder, Schizoaffective,Disorder, Schizophreniform,Disorders, Psychotic,Disorders, Schizoaffective,Disorders, Schizophreniform,Psychoses, Brief Reactive,Psychotic Disorder,Reactive Psychoses, Brief,Reactive Psychosis, Brief,Schizoaffective Disorders,Schizophreniform Disorder
D003866 Depressive Disorder An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. Depression, Endogenous,Depression, Neurotic,Depression, Unipolar,Depressive Syndrome,Melancholia,Neurosis, Depressive,Unipolar Depression,Depressions, Endogenous,Depressions, Neurotic,Depressions, Unipolar,Depressive Disorders,Depressive Neuroses,Depressive Neurosis,Depressive Syndromes,Disorder, Depressive,Disorders, Depressive,Endogenous Depression,Endogenous Depressions,Melancholias,Neuroses, Depressive,Neurotic Depression,Neurotic Depressions,Syndrome, Depressive,Syndromes, Depressive,Unipolar Depressions
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001008 Anxiety Disorders Persistent and disabling ANXIETY. Anxiety Neuroses,Anxiety States, Neurotic,Neuroses, Anxiety,Anxiety Disorder,Anxiety State, Neurotic,Disorder, Anxiety,Disorders, Anxiety,Neurotic Anxiety State,Neurotic Anxiety States,State, Neurotic Anxiety,States, Neurotic Anxiety
D001569 Benzodiazepines A group of two-ring heterocyclic compounds consisting of a benzene ring fused to a diazepine ring. Benzodiazepine,Benzodiazepine Compounds
D013375 Substance Withdrawal Syndrome Physiological and psychological symptoms associated with withdrawal from the use of a drug after prolonged administration or habituation. The concept includes withdrawal from smoking or drinking, as well as withdrawal from an administered drug. Drug Withdrawal Symptoms,Withdrawal Symptoms,Drug Withdrawal Symptom,Substance Withdrawal Syndromes,Symptom, Drug Withdrawal,Symptom, Withdrawal,Symptoms, Drug Withdrawal,Symptoms, Withdrawal,Syndrome, Substance Withdrawal,Syndromes, Substance Withdrawal,Withdrawal Symptom,Withdrawal Symptom, Drug,Withdrawal Symptoms, Drug,Withdrawal Syndrome, Substance,Withdrawal Syndromes, Substance

Related Publications

C Schmauss, and S Apelt, and H M Emrich
September 1996, Psychiatrische Praxis,
C Schmauss, and S Apelt, and H M Emrich
November 1997, Psychiatrische Praxis,
C Schmauss, and S Apelt, and H M Emrich
March 1989, Pharmacopsychiatry,
C Schmauss, and S Apelt, and H M Emrich
November 1999, Psychopharmacology,
C Schmauss, and S Apelt, and H M Emrich
April 1981, British heart journal,
C Schmauss, and S Apelt, and H M Emrich
May 1997, Drug and alcohol dependence,
C Schmauss, and S Apelt, and H M Emrich
September 2014, Drug and alcohol dependence,
C Schmauss, and S Apelt, and H M Emrich
December 1988, Acta psychiatrica Scandinavica,
C Schmauss, and S Apelt, and H M Emrich
March 2000, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine,
Copied contents to your clipboard!