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Study, Apr/22: Phenobarbital use in benzodiazepine and z-drug detoxification...


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The full title of this Italian study is "Phenobarbital use in benzodiazepine and z-drug detoxification: a single-centre 15-year observational retrospective study in clinical practice".

 

https://pubmed.ncbi.nlm.nih.gov/35412225/

 

Abstract

 

Given the increase in benzodiazepine (BZD) and Z-drug (ZD) use disorder, this study described the use of phenobarbital (PHB) as detoxification in clinical practice. A 15-year observational retrospective study was performed on medical records of BZD-ZD use disorder patients detoxified with PHB at the Toxicology Unit and Poison Centre, Careggi University Hospital, Florence (Italy). A multivariate logistic regression was used to estimate odd ratios (ORs) and related 95% confidence intervals (CI) of "treatment failure" considering demographic and pharmacological characteristics. "Hospitalisation length", "PHB discharge dose", and "BZD-ZD free status" at discharge were also calculated. During detoxification, out of 355 patients (57% of men), with a mean age of 42.92 years, only 20 (5.6%) treatment failures were recorded: 19 were discharged against medical advice or due to misbehaviour, and only one for PHB-related non-serious skin rash. Analysis showed a higher probability to be BZD-ZD free at discharge for subjects who reported to be employed (OR 2.29; CI 95% 1.00-5.24), for those who abused oral drops of BZD-ZD (OR 2.16, CI 1.30-3.59), and for those treated with trazodone (OR 2.86, CI 1.14-7.17) during hospital stay. A hospitalisation length of > 7 days was observed for patients with opioid maintenance therapy (OR 2.07, CI 1.20-3.58) for substance use disorder, and for those treated with more than 300 mg/day of PHB equivalents at hospital admission (OR 1.68, CI 1.03-2.72). Our results suggested that PHB can be considered a valuable detoxification option for different types of BZD and ZD use disorder patients.

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Thank you for finding and sharing this, Lapis2. I’ve included a link to the full text below.  As the authors note, a major limitation of this study is that it did not include a post-detox followup component.

 

Phenobarbital use in benzodiazepine and z-drug detoxification: a single-centre 15-year observational retrospective study in clinical practice

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9001824/

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I was prescribed Primidone (another version and synthesis of Phenobarb) during the first half of my Klonopin withdrawal. I'm pretty sure that whenever I quit taking it, it threw me back into acute withdrawal. Although I'm not sure if it was the primidone, as I quit taking propranolol at the same time about a year or two ago.
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It's one thing to get a medication out of the body, but it's quite another to recover from long-term use of benzodiazepines. I think most of us have found out the hard way that it can take awhile. Unfortunately, I haven't come across many studies where people are actually followed over a long period of time, and I assume it's very hard to do such a study.
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It's interesting to me that a study is actually using the phrase "benzodiazepine (BZD) and Z-drug (ZD) use disorder".

 

That's a phrase more medical professionals need to become acquainted with.

 

 

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