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Benzodiazepines in addition to antidepressants in the treatment of depression. How high is the risk to induce dependence?
419 Porsolt, R.D., Lenegre, A., Caignard, D.H., Pfeiffer, B., Mocaer, E. and Guardiola-Lemaitre, B. (1992) Drug Dev. Res. 27, 389402.
Benzodiazepines in addition to antidepressants in the treatment of depression. How high is the risk to induce dependence?
D. N a b e r and R. Holzbach Psychiatric Hos'pital, University of Munich, 8000 Mffnchen 2, Germany Key words'. Benzodiazepines; Depression; Dependency Due to the delayed efficacy of antidepressants, it is common practice to treat patients, particularly if they are suicidal or agitated, additionally with benzodiazepines (BDZ). This combination seems to be effective and as short-term treatment without major unwanted effects. However, sometimes the original intention to withdraw BDZ within 1-2 weeks or at least within in-patient treatment is not realized and medication at dismissal includes BDZ. The risk of inducing long-term treatment or BDZ dependence in these patients is not known. Charts of 885 (507 endogenous and 378 neurotic) depressed in-patients were analyzed regarding a.o. medication and psychopathology. If medication at dismissal included BDZ, 9 15 months later, patients and their doctors were asked about the actual psychopathology and medication. Not treated with BDZ were 45% of patients. 30% received BDZ, but no longer at dismissal. 12% received BDZ at dismissal, but not at follow-up. 8% still took BDZ at follow-up. No information (address unknown n - 2 9 , death n = 14, refusal n = 6) was available for 6%. The comparison of patients' and doctors' data revealed differences concerning BDZ in I 1 of 172 patients. Compared to the dosage at dismissal, BDZ dose at follow-up (no change of mean values: 8.7 _+ 9.9 vs. 8.3 ± 9.4 mg diazepam equivalents) was decreased in 46%, increased in 28% and constant in 25%. The actual dosage was < 5 mg in 54%, 5-8 mg in 21%, 10~12 mg in 13%, 16 20 mg in 9% and 23-28 mg in 3%. The 68 patients with BDZ at follow-up (68% already had BDZ prior to index hospitalization) did not differ in psychopathology or BDZ dosage, but were older, more often female, socially isolated, somatically ill and endogenous depressed. Withdrawal from flunitrazepam and lorazepam was significantly less frequent than from dipotassium chlorazepate and diazepam. These data indicate that in former depressed inpatients, the development of BDZ long-term treatment or (low-dose) dependence is not very frequent and mostly restricted to the well-known risk group. Only individually can it be decided whether subjective improvement by BDZ justifies the risk of abuse or dependence. This issue is currently and widely discussed. This debate needs data, not just opinions.
Effects of S.12024-2 on memory impairment in aged rats
P. Lacroix a, J.M. Reymann b, N. Rocher a, H. Allain b, I. CastagnU and D. Guez c "Department of Preclinical Studies, Biotrial, 35000 Rennes, France, bLaboratory of Clinical and Experimental Pharmacology, FacultO de MOdecine, 35043 Rennes, France and ~Institut "de Recherches Internationales Servier, 92415 Courbevoie, France Key words: Memory impairment; Aged rat; Water maze; Reference memory; Cognitive enhancer; S.12024-2 The effects of S.12024-2 (R,S l-methyl 8-(2-morpholinylmethoxy)-l,2,3,4-tetrahydroquinolinemethane sulphonate) have been examined in a series of behavioural tests to determine its potential use as a cognition enhancer. The present study
Benzodiazepines in addition to antidepressants in the treatment of depression. How high is the risk to induce dependence?
D. N a b e r and R. Holzbach Psychiatric Hos'pital, University of Munich, 8000 Mffnchen 2, Germany Key words'. Benzodiazepines; Depression; Dependency Due to the delayed efficacy of antidepressants, it is common practice to treat patients, particularly if they are suicidal or agitated, additionally with benzodiazepines (BDZ). This combination seems to be effective and as short-term treatment without major unwanted effects. However, sometimes the original intention to withdraw BDZ within 1-2 weeks or at least within in-patient treatment is not realized and medication at dismissal includes BDZ. The risk of inducing long-term treatment or BDZ dependence in these patients is not known. Charts of 885 (507 endogenous and 378 neurotic) depressed in-patients were analyzed regarding a.o. medication and psychopathology. If medication at dismissal included BDZ, 9 15 months later, patients and their doctors were asked about the actual psychopathology and medication. Not treated with BDZ were 45% of patients. 30% received BDZ, but no longer at dismissal. 12% received BDZ at dismissal, but not at follow-up. 8% still took BDZ at follow-up. No information (address unknown n - 2 9 , death n = 14, refusal n = 6) was available for 6%. The comparison of patients' and doctors' data revealed differences concerning BDZ in I 1 of 172 patients. Compared to the dosage at dismissal, BDZ dose at follow-up (no change of mean values: 8.7 _+ 9.9 vs. 8.3 ± 9.4 mg diazepam equivalents) was decreased in 46%, increased in 28% and constant in 25%. The actual dosage was < 5 mg in 54%, 5-8 mg in 21%, 10~12 mg in 13%, 16 20 mg in 9% and 23-28 mg in 3%. The 68 patients with BDZ at follow-up (68% already had BDZ prior to index hospitalization) did not differ in psychopathology or BDZ dosage, but were older, more often female, socially isolated, somatically ill and endogenous depressed. Withdrawal from flunitrazepam and lorazepam was significantly less frequent than from dipotassium chlorazepate and diazepam. These data indicate that in former depressed inpatients, the development of BDZ long-term treatment or (low-dose) dependence is not very frequent and mostly restricted to the well-known risk group. Only individually can it be decided whether subjective improvement by BDZ justifies the risk of abuse or dependence. This issue is currently and widely discussed. This debate needs data, not just opinions.
Effects of S.12024-2 on memory impairment in aged rats
P. Lacroix a, J.M. Reymann b, N. Rocher a, H. Allain b, I. CastagnU and D. Guez c "Department of Preclinical Studies, Biotrial, 35000 Rennes, France, bLaboratory of Clinical and Experimental Pharmacology, FacultO de MOdecine, 35043 Rennes, France and ~Institut "de Recherches Internationales Servier, 92415 Courbevoie, France Key words: Memory impairment; Aged rat; Water maze; Reference memory; Cognitive enhancer; S.12024-2 The effects of S.12024-2 (R,S l-methyl 8-(2-morpholinylmethoxy)-l,2,3,4-tetrahydroquinolinemethane sulphonate) have been examined in a series of behavioural tests to determine its potential use as a cognition enhancer. The present study