Study, May/19:High-dose lormetazepam dependence: case of Dr. Jekyll & Mr. Hyde

The full title of this Italian study is "High-dose lormetazepam dependence: strange case of Dr. Jekyll and Mr. Hyde".

 

https://www.ncbi.nlm.nih.gov/pubmed/31076977

 

Abstract

 

High-dose benzodiazepine (BZD) abuse is emerging as a substance use disorder (SUD). The aim of the study is to explore the impact of high-dose lormetazepam (LMZ) abuse and the characteristics of patients affected by this SUD in a tertiary referral addiction unit. We have retrospectively evaluated 1112 patients admitted to the Addiction Medicine Unit, Verona University Hospital, Italy for detoxification from high-dose BZD dependence. LMZ was the most common BZD, with an increasing prevalence from January 2003 to June 2018. Socio-demographic (more women; higher age and education) and clinical features (higher daily diazepam dosage equivalent, BZD abuse duration, age of first BZD intake; BZD prescribed more frequently for sleep disorders; less frequent history of other SUDs, previous/active alcohol, previous opioids abuse; more frequent overall major psychiatric diseases and major depression; less-frequent bipolar disorders and other psychoses, personality disorders, and more than one psychiatric disease) of LMZ vs. other BZD abusers significantly differed. 96.7% LMZ abusers took oral solution, while two-thirds of other BZD abusers took tablets. Oral solution, BZD abuse duration and prescription of BZD for sleep disorders increased, while history of other SUDs, previous/active alcohol and active cannabinoids SUD reduced the risk of high-dose LMZ vs. other BZDs abuse. The large prevalence of high-dose LMZ abusers in Italy may be strongly related to the availability and characteristics of oral formulation that may transform the innocuous Dr. Jekyll tablets into an evil Mr. Hyde. Restriction to the market of LMZ oral formulation might reduce the risk of high-dose abuse.

The oral solution IS a real problem.

 

I was given it once in a hospital and whooohoo! I have never experienced something to act faster. On the tongue - and you are calm.

The first thought I had then was "wow, THIS could make me addicted very very quickly just because I react so fast".

 

They give it to me because I was not able to talk to the doctor. Each patient was given it, just at the beginning of a talk. Nice idea. Really nice.

 

I am so so sorry for all people who took that, no matter if low or high dosage :'(

Oh my goodness, Marigold! That's scary!

 

Good way to make people acquiescent, I suppose...if that's what they want.

Maybe relevant, maybe not but my recollection is that the lead author of this study works at a clinic that promotes the use of Flumazenil for rapid detox from benzos.

Maybe relevant, maybe not but my recollection is that the lead author of this study works at a clinic that promotes the use of Flumazenil for rapid detox from benzos.

 

i am from germany and out of my personal experience (I have read a lot of studies) the studies made in Germany, Italy and Spain are not really ..uhm.. reliable or were not made to help patients. I do not like how they talk about the patients and the level of knowledge seems very low. I "prefer" studies from outside Europe or scandinavian countries, if one can prefer such things..

I don't really feel like I'm in a position to generalize about that, but I do think we should be skeptical and critical when reading studies. Of course, these aren't full studies that we're looking at -- just abstracts -- so they're summaries rather than detailed reports.

 

Libertas, are you talking about Lugoboni? That's the name I recognized from previous studies that I've come across. I can't tell who is the "lead author" here, though. I just figured they're all equally involved.