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.
- MeSH
- Substance Withdrawal Syndrome etiology MeSH
- Adult MeSH
- GABA Modulators administration & dosage adverse effects blood MeSH
- Clonazepam administration & dosage adverse effects blood MeSH
- Humans MeSH
- Drug Monitoring * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- MeSH
- Algorithms MeSH
- Anticonvulsants * administration & dosage therapeutic use MeSH
- Diazepam administration & dosage therapeutic use MeSH
- Child MeSH
- Adult MeSH
- Epilepsy, Tonic-Clonic drug therapy MeSH
- Epilepsy * diagnosis drug therapy MeSH
- Phenobarbital administration & dosage therapeutic use MeSH
- Phenytoin administration & dosage therapeutic use MeSH
- GABA Modulators administration & dosage therapeutic use MeSH
- Infant MeSH
- Valproic Acid analogs & derivatives administration & dosage therapeutic use MeSH
- Humans MeSH
- Medication Therapy Management MeSH
- Midazolam administration & dosage therapeutic use MeSH
- Neurosurgical Procedures MeSH
- Infant, Newborn MeSH
- Intraoperative Care MeSH
- Propofol administration & dosage therapeutic use MeSH
- Drug Administration Schedule MeSH
- Medical Order Entry Systems MeSH
- Thiopental administration & dosage therapeutic use MeSH
- Organ Transplantation MeSH
- Seizures * drug therapy classification MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Infant MeSH
- Humans MeSH
- Infant, Newborn MeSH
- Keywords
- α2-δ podjednotka kalciových kanálů, klinické studie,
- MeSH
- Antidepressive Agents, Tricyclic administration & dosage therapeutic use MeSH
- Antidepressive Agents pharmacology classification therapeutic use MeSH
- Diagnosis, Differential MeSH
- Pharmacologic Actions MeSH
- Drug Therapy MeSH
- GABA Modulators administration & dosage adverse effects MeSH
- gamma-Aminobutyric Acid analogs & derivatives pharmacology therapeutic use MeSH
- Drug Evaluation MeSH
- Clinical Trials as Topic MeSH
- Comorbidity MeSH
- Humans MeSH
- Neuralgia etiology drug therapy classification MeSH
- Pregabalin MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
