High dose benzodiazepine dependence: Description of 29 patients treated with flumazenil infusion and stabilised with clonazepam

Gianluca Quaglio, Cristian Pattaro, Gilberto Gerra, Sophie Mathewson, Paul Verbanck, Don C. Des Jarlais, Fabio Lugoboni

Research output: Contribution to journalArticle

Abstract

The withdrawal syndrome from benzodiazepine (BZD) can be severe and in some cases may impede cessation of the use of the drug. We present here a case series of benzodiazepine detoxification by flumazenil infusion, stabilised with clonazepam. Patients were treated with flumazenil 1.35. mg/day for a median of 7. days. Self-reported physical withdrawal symptoms were recorded daily. In addition to flumazenil, antidepressants were given before treatment commenced and clonazepam was administered nightly with both being continued after discharge. Twenty-nine patients were treated. No patients dropped out from the treatment programme. Nine patients (31%) required a temporary reduction/cessation of the infusion. The linear trend in the reduction of the daily withdrawal scores in the overall study population was significant. The linear trends were also significant in the group of patients for whom a temporary reduction/suspension of the flumazenil was required. Six months after treatment, 15 patients (53%) were abstinent from clonazepam and other BZDs. For five (21%) the BZD dependence were reinstated. More than two-thirds of the subjects tolerated the procedure well and about half had a good long term response. Slow flumazenil infusion appears to merit consideration as a possible future treatment. Suggestions for future research are examined.

Original languageEnglish (US)
Pages (from-to)457-462
Number of pages6
JournalPsychiatry Research
Volume198
Issue number3
DOIs
StatePublished - Aug 15 2012

Keywords

  • Benzodiazepine withdrawal
  • Clonazepam
  • Dependence
  • Detoxification
  • Flumazenil

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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