DSM-III-R co-morbidity in benzodiazepine dependence.

UNLABELLED: AIM, SAMPLE AND MEASURES: Co-morbidity has been shown to influence the clinical course of mental disorders. This paper describes DSM-III-R 1-month co-morbidity across axes I, II and III in a sample of 153 benzodiazepine dependents. All patients were evaluated through several in-depth clinical interviews across all five DSM-III-R axes. RESULTS: Extensive co-morbidity existed across three DSM-III-R axes. All patients had at least one diagnosis in axis I; 81 (52.9%) in axis II and 50 (32.7%) in axis III. The most prevalent diagnoses were: insomnia, anxiety disorders and affective disorders in axis I; obsessive-compulsive, histrionic and dependent personality disorders in axis II and rheumatological, neurological and cardiovascular disorders in axis III. CONCLUSIONS: There were no cases of benzodiazepine dependence appearing alone. There were associations within and between axes, suggesting potential predisposing factors and a sequential model for benzodiazepine dependence is proposed. The findings reinforce the need for exhaustive diagnostic evaluation of patients prior to prescribing benzodiazepine.

Benzodiazepine types in high versus therapeutic dose dependence.

Two types of benzodiazepine dependence have been described: high vs. therapeutic dose dependence. So far, no systematic research has been conducted regarding the frequency with which the various benzodiazepines are represented in one type or the other. In this study, 153 dependent patients using 14 different benzodiazepines were evaluated to assess the prevalence of their use among high vs. therapeutic dose dependents. Triazolam was the single drug most frequently used by high-dose dependents, followed by Lorazepam. No significant differences were found among benzodiazepines regarding their use by therapeutic dose dependents. Our data shows that pharmacokinetic and pharmacodynamic factors appear to be related to the frequency with which the different benzodiazepines are used by high and therapeutic dose dependents.

Benzodiazepine withdrawal syndrome seizures.

In this study, we present five cases of seizures following withdrawal of flunitrazepam, lorazepam, or triazolam, representing 3% of a sample consisting of 153 patients dependent on benzodiazepines. Both abrupt cessation of benzodiazepine intake and high-dose use seem to be critical for the appearance of seizures. Pharmacological features, such as short elimination half-life and high potency, might explain the higher risk of seizures observed in these patients.

Daytime consumption of triazolam.

Six cases of daytime use of triazolam are reported. In all cases, daytime anxiety following the night-time use of this short-acting, high-potency hypnotic benzodiazepine led to the use of the drug during the day. Tolerance to the hypnotic and anxiolytic effects of the drug developed, as shown by a significant escalation of both the bedtime and daytime doses.

[Secondary effects of lithium. Their evaluation]. / Efectos secundarios del litio. Su valoración.

A groupe of 52 patients in long-term lithium treatment were questioned about side effects. The K. Ghose questionnaire was used which contained 36 items. The most frequent complaints were hand-tremor, dry mouth, poor memory, polyuria, diarrhoea, weight gain. We hypothesize that apart from symptoms clearly demonstrated to be caused by lithium treatment (polyuria, hand-tremor, weight gain diarrhoea). Other complaints such as dry mouth, poor memory or skin eruptions occur frequently and they are also related to lithium.