Prolonged Benzodiazepine Levels Following Withdrawal in Alcohol Dependence. 2023

Hilary J Little, and Kim Donoghue, and Colin Drummond
Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, London, United Kingdom.

This article presents the benzodiazepine concentrations in urine samples from participants undergoing alcohol withdrawal in a Phase 4 "Proof of Concept" double-blind, randomized, controlled clinical trial. Chlordiazepoxide was prescribed to all participants "as needed" during the first 2 weeks only of alcohol withdrawal, to prevent serious consequences such as seizures. The trial examined effects of either mifepristone or placebo on the primary trial outcomes, which included cognitive function tests at 3 weeks and 4 weeks after the cessation of drinking. Because benzodiazepines are known to affect memory, urine benzodiazepine concentrations were measured before cognitive testing. Urine samples were collected from participants immediately before each cognitive testing session, and the concentrations of unconjugated benzodiazepines (i.e., compounds active at benzodiazepine receptors) were measured by standard assay, using mass spectrometry. The urine benzodiazepine measurements showed clearly that amounts of active benzodiazepine metabolites were present during the third and fourth weeks after the cessation of drinking that were as high as or higher than those seen after therapeutic dosing. The urinary benzodiazepine concentrations demonstrated that residual active benzodiazepine compounds can be present up to 2 weeks after the last ingestion. This could affect the results of cognitive testing in people with alcohol dependence undergoing detoxification.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000437 Alcoholism A primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic. (Morse & Flavin for the Joint Commission of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine to Study the Definition and Criteria for the Diagnosis of Alcoholism: in JAMA 1992;268:1012-4) Alcohol Abuse,Alcoholic Intoxication, Chronic,Ethanol Abuse,Alcohol Addiction,Alcohol Dependence,Alcohol Use Disorder,Abuse, Alcohol,Abuse, Ethanol,Addiction, Alcohol,Alcohol Use Disorders,Chronic Alcoholic Intoxication,Dependence, Alcohol,Intoxication, Chronic Alcoholic,Use Disorders, Alcohol
D000987 Antisocial Personality Disorder A personality disorder whose essential feature is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood. The individual must be at least age 18 and must have a history of some symptoms of CONDUCT DISORDER before age 15. (From DSM-IV, 1994). Antisocial Behavior,Deviant Behavior,Dyssocial Behavior,Personality Disorder, Antisocial,Psychopathic Personality,Sociopathic Personality,Antisocial Personality,Antisocial Behaviors,Antisocial Personalities,Antisocial Personality Disorders,Behavior, Antisocial,Behavior, Deviant,Behavior, Dyssocial,Behaviors, Antisocial,Behaviors, Deviant,Behaviors, Dyssocial,Deviant Behaviors,Disorder, Antisocial Personality,Disorders, Antisocial Personality,Dyssocial Behaviors,Personalities, Antisocial,Personalities, Psychopathic,Personalities, Sociopathic,Personality Disorders, Antisocial,Personality, Antisocial,Personality, Psychopathic,Personality, Sociopathic,Psychopathic Personalities,Sociopathic Personalities
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

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