A double-blind placebo-controlled study of buspirone in diazepam withdrawal in chronic benzodiazepine users

Article Abstract:

Buspirone is a relatively new anti-anxiety drug. To evaluate its use in withdrawal from benzodiazepines (another class of anti-anxiety drug), 23 adult benzodiazepine-addicted patients participated in a 20-week, double-blind placebo study (neither the experimenters nor the patients knew which patients were receiving a placebo). Eleven of the patients were randomly assigned to receive buspirone, and 12 were assigned to receive placebos. For the first month, all patients were maintained on their usual doses of diazepam (a benzodiazepine). Over the next month, either buspirone or placebo was added. During the third month, the diazepam was gradually withdrawn while patients continued to take either buspirone or placebo. At the start of the fourth month, diazepam was completely stopped, but both groups were given placebo syrup and told it was diazepam. During the final month, the placebo syrup and the buspirone were both stopped, and both groups took only placebo pills. In both groups, scores for all withdrawal symptoms rose during diazepam withdrawal. The average withdrawal symptom scores were significantly higher in the buspirone group; overall outcome was significantly better in the placebo group. At six months and at one year after diazepam withdrawal, 11 of the 12 placebo-group patients remained benzodiazepine-free, while only six of the 11 buspirone-group patients did. Buspirone was shown to be ineffective in benzodiazepine detoxification, and seemed to also have markedly adverse effects on the course and outcome of withdrawal. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Complications and side effects, Drug withdrawal symptoms, Substance withdrawal syndrome, Benzodiazepine abuse, Diazepam, Buspirone hydrochloride, Buspirone

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The Dexamethasone Suppression Test in children: Lack of an association with diagnosis

Article Abstract:

The Dexamethasone Suppression Test (DST) has been useful in distinguishing among different types of depression in adults and has therefore been a useful diagnostic tool. Briefly, the ability of dexamethasone to suppress cortisol production is compromised in patients with certain types of depression. (Dexamethasone is a synthetic glucocorticoid drug. Cortisol is a hormone secreted by the cortex of the adrenal gland.) The present study sought to determine the utility of the DST in diagnosing depression in children. Forty-four children who had been diagnosed with depression by standard evaluation tools agreed to undergo the DST after completing an initial interview. (Consent was also obtained from a parent.) The test required that a blood sample be drawn to determine the baseline blood cortisol level. Dexamethasone 0.5 mg (milligrams) or dexamethasone 1.0 mg (dependent upon body weight) was administered, and another blood sample was obtained 17 hours later for measuring the level of cortisol. The results of the two tests were compared. Of the 44 patients, 22 did not suppress cortisol production after the administration of dexamethasone. A comparison with data from the standard instruments used to assess depression in these children indicated that there was no consistent relation between the diagnosis of depression and the effects of dexamethasone. Therefore, pending further study, the DST does not appear to have a similar ability to detect and differentiate depression in children as it does in adults. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Dexamethasone, Depression in children, Childhood depression

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Patterns of benzodiazepine use in Great Britain as measured by a general population survey

Article Abstract:

A 1985 British survey of 4,148 people was performed to assess the prevalence and pattern of benzodiazepine use. Benzodiazepines are antianxiety drugs that reduce agitation, restlessness, and muscle tension. The annual prevalence rate for benzodiazepine use among the group surveyed was 7.7 percent. Among the 318 users, the female to male ratio was two to one. Forty-two subjects had used two or more different benzodiazepines. Use was shown to increase with age. Ninety-one percent of benzodiazepine prescriptions were for anxiety, insomnia, depression, injury, or epilepsy. Anxiety and depression were common among young and middle-aged individuals. Sleep disorders were most common among women over 65 years of age. Those who used benzodiazepines on a daily basis for long periods of time tended to be older. When results were compared with a 1981 survey, a decrease in usage from 9.4 to 7.7 percent was indicated. However, in the earlier survey 27.4 percent were regular users, while 52.2 percent were regular users in 1985. Dependency and withdrawal problems were more common in those who were over 45 years of age and among those who used benzodiazepines for over 12 months. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surveys, England, Drug utilization, Drug monitoring, Benzodiazepines, Psychopharmacology, Great Britain

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