Martin-Kleisch A, Zulfiqar A-A
Service d'acceuil des urgences, centre hospitalier de Soissons, 02209 Soissons cedex, France.
Département de médecine interne, gériatrie, thérapeutique, CHU de Rouen, hôpital Saint-Julien, 2, rue Danton, 76141 Le Petit-Quevilly, France.
Ann Pharm Fr. 2017 May;75(3):196-208. doi: 10.1016/j.pharma.2016.11.003. Epub 2016 Dec 22.
Benzodiazepines are prescribed in many indications and are provider of adverse effects in case of abrupt withdrawal or poorly framed. Withdrawal rules are established by the High Authority for Health.
To evaluate the diagnostic and therapeutic modalities of the benzodiazepine withdrawal syndrome, we performed a retrospective single-center study at the University Hospital of Reims, between January 2000 and May 2015, in patients with a withdrawal syndrome following hospital coding. A collection of clinical and laboratory data was performed for each patient, as well as how to obtain the diagnosis, their care and their future.
Sixty-eight cases were initially collected, but 16 cases were included. In benzodiazepine withdrawal took place outside the hospital in 68% of cases. The causes were varied: lack of renewal, not issued by the pharmacist, pill errors. Disorders found during the withdrawal symptoms were variable, there were particular digestive, neurological and psychiatric disorders. The use of biological assessments did not provide diagnostic support, however, in 68% of cases a toxicological assay has helped to support. The management of the withdrawal syndrome has been done primarily by reintroducing the same treatment (60%), while in 27% of alprazolam is introduced relay benzodiazepines. It is noted one death possibly linked to the withdrawal syndrome.
Despite recommendations and information about the terms of stops, some clinical situations result in withdrawal symptoms, a patient died in our study, death appears in connection with the withdrawal situation. Note that the human factor is the main factor related to the circumstances of occurrence of withdrawal.
苯二氮䓬类药物被用于多种适应症，若突然停药或用药不当会产生不良反应。卫生高级管理局制定了停药规则。
为评估苯二氮䓬类药物戒断综合征的诊断和治疗方式，我们于2000年1月至2015年5月在兰斯大学医院进行了一项回顾性单中心研究，研究对象为医院编码后出现戒断综合征的患者。对每位患者进行了临床和实验室数据收集，以及如何获得诊断、他们的治疗情况和未来状况。
最初收集了68例病例，但纳入了16例。68%的苯二氮䓬类药物停药发生在院外。原因多种多样：未续药、药剂师未发放、用药错误。戒断症状期间发现的病症各不相同，有特殊的消化系统、神经系统和精神系统病症。生物学评估未提供诊断支持，然而，68%的病例中，毒理学检测有助于提供支持。戒断综合征的处理主要是重新引入相同治疗（60%），而27%的情况是引入阿普唑仑作为苯二氮䓬类药物的替代。注意到有1例死亡可能与戒断综合征有关。
尽管有关于停药条件的建议和信息，但一些临床情况仍会导致戒断症状，我们的研究中有1例患者死亡，死亡似乎与停药情况有关。需注意人为因素是与停药发生情况相关的主要因素。
