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A Case Report of Clonazepam Dependence: Utilization of Therapeutic Drug Monitoring During Withdrawal Period
I. Kacirova, M. Grundmann, P. Silhan, H. Brozmanova,
Jazyk angličtina Země Spojené státy americké
Typ dokumentu kazuistiky, časopisecké články
NLK
Directory of Open Access Journals
od 2014
PubMed Central
od 2013 do Před 2 týdny
Europe PubMed Central
od 2013
Open Access Digital Library
od 2013-01-01
Open Access Digital Library
od 2014-01-01
- MeSH
- abstinenční syndrom etiologie MeSH
- dospělí MeSH
- GABA modulátory aplikace a dávkování škodlivé účinky krev MeSH
- klonazepam aplikace a dávkování škodlivé účinky krev MeSH
- lidé MeSH
- monitorování léčiv * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Clonazepam is long-acting benzodiazepine agonist used in short-acting benzodiazepine withdrawal; however, recent observations suggest the existence of its abuse. We demonstrate a 40-year-old man with a 20-year history of psychiatric care with recently benzodiazepine dependence (daily intake of ∼60 mg of clonazepam and 10 mg of alprazolam). High serum levels of both drugs were analyzed 3 weeks before admission to hospitalization (clonazepam 543.9 ng/mL, alprazolam 110 ng/mL) and at the time of admission (clonazepam 286.2 ng/mL, alprazolam 140 ng/mL) without any signs of benzodiazepine intoxication. Gradual withdrawal of clonazepam with monitoring of its serum levels and increase of gabapentin dose were used to minimize physical signs and symptoms of clonazepam withdrawal. Alprazolam was discontinued promptly. Clinical consequences of the treatment were controllable tension, intermittent headache, and rarely insomia. It is the first case report showing utilization of therapeutic drug monitoring during withdrawal period in the patient with extreme toleration to severe benzodiazepine dependence.
Department of Clinical Pharmacology Department of Laboratory Diagnostics
Department of Psychiatry University Hospital Ostrava Czech Republic
From the Department of Clinical Pharmacology Faculty of Medicine University of Ostrava
Citace poskytuje Crossref.org
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