Latifi-Pour Masoud, Hassanian-Moghaddam Hossein, Mortazavi Helya-Sadat, Shadnia Shahin, Zamani Nasim, Rahimi Mitra
Toxicological Research Center and Excellence Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital Poison Center, Shahid Beheshti University of Medical Sciences, Kamali Avenue, South Karegar Street, Tehran, Iran.
Curr Clin Pharmacol. 2020;15(1):81-88. doi: 10.2174/1574884714666190112153157.
Benzodiazepine is one of the most important causes of substance abuse and intoxication throughout the world and Iran.
The aim of our study is to determine the role of stimulants in reversing CNS level in acute Benzodiazepine poisoning patients who were hospitalized at referral poison center.
This was a randomized double-blind placebo-controlled trial study on 32 cases with pure acute Benzodiazepine poisoning from March 2016 to February 2017. Diagnosis of pure acute poisoning was based on history, and laboratory confirmation. We gathered the demographics, clinical data, laboratory data, hospitalization and outcome. Participants were randomized into two groups: Methylphenidate Group (MPH) and Placebo Group (PBO).
The randomized sample consisted of 32 participants who were predominately female (83%). The majority of the PBO group and the MPH group reported improvement in their consciousness with a significant difference between the two groups (p = .005). Paired sample t-test analyses on Reed Scale data revealed an increase in the probability of improvement during the trial for the MPH group compared to the PBO group. Furthermore, the HCo3 (bicarbonate) level has a significant p-value with respect to age groups (p = .02). None of our cases required either the ICU facility or intubation.
Our study provided the MPH superiority over PBO in reversing CNS symptoms in loss of consciousness in acute BZD poisoned patients. Thus, this trial provides concrete evidence that improvement in consciousness levels (Reed Scale rated) among those patients receiving MPH was associated with a methylphenidate use.
苯二氮䓬类药物是全球及伊朗药物滥用和中毒的最重要原因之一。
我们研究的目的是确定兴奋剂在逆转转诊中毒中心住院的急性苯二氮䓬类药物中毒患者中枢神经系统水平方面的作用。
这是一项随机双盲安慰剂对照试验研究，于2016年3月至2017年2月对32例单纯急性苯二氮䓬类药物中毒患者进行。单纯急性中毒的诊断基于病史和实验室确诊。我们收集了人口统计学、临床数据、实验室数据、住院情况及结果。参与者被随机分为两组：哌甲酯组（MPH）和安慰剂组（PBO）。
随机样本包括32名参与者，其中大多数为女性（83%）。大多数安慰剂组和哌甲酯组报告意识有所改善，两组之间存在显著差异（p = 0.005）。对里德量表数据进行的配对样本t检验分析显示，与安慰剂组相比，哌甲酯组在试验期间改善的可能性增加。此外，碳酸氢盐（HCo3）水平在不同年龄组中有显著的p值（p = 0.02）。我们的病例均无需重症监护病房设施或插管。
我们的研究表明，在逆转急性苯二氮䓬类药物中毒患者意识丧失的中枢神经系统症状方面，哌甲酯优于安慰剂。因此，本试验提供了确凿证据，表明接受哌甲酯治疗的患者意识水平（里德量表评分）的改善与哌甲酯的使用有关。
