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  1. Article: Intractable nausea caused by zolpidem withdrawal: a case report.

    Baruch, Edward / Vernon, Leonard F / Hasbun, Rafael J

    Journal of addiction medicine

    2007  Volume 1, Issue 1, Page(s) 48–50

    Abstract: First launched in France in 1988, zolpidem (Ambien®) is a short-acting hypnotic agent. Early studies reported that that the development of physical dependence and tolerance to sedative-hypnotic drugs, such as the depressant and anticonvulsant effects ... ...

    Abstract First launched in France in 1988, zolpidem (Ambien®) is a short-acting hypnotic agent. Early studies reported that that the development of physical dependence and tolerance to sedative-hypnotic drugs, such as the depressant and anticonvulsant effects evidenced with benzodiazepines, is not found with zolpidem. Direct to consumer advertising by the manufacturer continues to state that the risk for dependency is low; however, recent publications seem to contradict this. Additionally, adverse drug reactions affecting the central nervous system, gastrointestinal tract, and respiratory system have been reported. Other studies have examined the interactions of selective serotonin reuptake inhibitors and zolpidem as a possible cause of hallucinations. With continued physician marketing efforts touting the safety and efficacy of zolpidem, there is a high likelihood to overlook the risk of dependency and the symptoms related to zolpidem withdrawal. We report a case of a 41-year-old female who developed a dependency to zolpidem, who on her own decided to decrease her dosage, resulting in intractable nausea requiring hospitalization. Reported cases of zolpidem withdrawal have occurred with doses in excess of 160 mg per day, none of these have reported with intractable nausea as the sole symptom. In our reported case, although exceeding recommended dosage withdrawal phenomenon seemed to be severe after withdrawal from a comparatively low dose of zolpidem. Before zolpidem is prescribed, patient education should include warnings about the potential problems associated with dependency and abrupt discontinuation. Education about this common and likely underrecognized clinical phenomenon will help prevent future episodes and minimize the risk of misdiagnosis.
    Language English
    Publishing date 2007-03
    Publishing country United States
    Document type Journal Article
    ISSN 1932-0620
    ISSN 1932-0620
    DOI 10.1097/ADM.0b013e31804259cb
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Two cases of severe gamma-hydroxybutyrate withdrawal delirium on a psychiatric unit: recommendations for management.

    Rosenberg, Mark H / Deerfield, Laurie J / Baruch, Edward M

    The American journal of drug and alcohol abuse

    2003  Volume 29, Issue 2, Page(s) 487–496

    Abstract: Many psychiatric professionals are unfamiliar with gamma-hydroxybutyrate (GHB), an increasingly popular drug of abuse. GHB withdrawal can lead to psychosis and agitation, and patients may present to psychiatric facilities for treatment. Withdrawal may ... ...

    Abstract Many psychiatric professionals are unfamiliar with gamma-hydroxybutyrate (GHB), an increasingly popular drug of abuse. GHB withdrawal can lead to psychosis and agitation, and patients may present to psychiatric facilities for treatment. Withdrawal may progress to delirium, with the potential for severe or even fatal medical complications. Therefore, it is imperative for psychiatric professionals to understand how to treat these patients. In this article, we describe two cases of severe GHB withdrawal syndrome that were treated in our inpatient psychiatric unit. These are among the most severe cases reported. Pertinent literature is reviewed and suggestions for treatment are discussed.
    MeSH term(s) Adult ; Anticonvulsants/therapeutic use ; Antihypertensive Agents/therapeutic use ; Clonazepam/therapeutic use ; Clonidine/therapeutic use ; Delirium/chemically induced ; Hospitalization ; Humans ; Lorazepam/therapeutic use ; Male ; Phenobarbital/therapeutic use ; Practice Guidelines as Topic ; Psychoses, Substance-Induced/drug therapy ; Psychoses, Substance-Induced/etiology ; Sodium Oxybate/adverse effects ; Substance Withdrawal Syndrome/drug therapy
    Chemical Substances Anticonvulsants ; Antihypertensive Agents ; Clonazepam (5PE9FDE8GB) ; Sodium Oxybate (7G33012534) ; Clonidine (MN3L5RMN02) ; Lorazepam (O26FZP769L) ; Phenobarbital (YQE403BP4D)
    Language English
    Publishing date 2003-07-04
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 193086-2
    ISSN 0095-2990
    ISSN 0095-2990
    DOI 10.1081/ada-120020529
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: A new instrument for measuring insight: the Beck Cognitive Insight Scale.

    Beck, Aaron T / Baruch, Edward / Balter, Jordan M / Steer, Robert A / Warman, Debbie M

    Schizophrenia research

    2004  Volume 68, Issue 2-3, Page(s) 319–329

    Abstract: The clinical measurements of insight have focused primarily on patients' unawareness of their having a mental disorder and of their need for treatment ([Acta Psychiatr. Scand. 89 (1994) 62; Am. J. Psychiatry 150 (1993) 873]; etc.). A complementary ... ...

    Abstract The clinical measurements of insight have focused primarily on patients' unawareness of their having a mental disorder and of their need for treatment ([Acta Psychiatr. Scand. 89 (1994) 62; Am. J. Psychiatry 150 (1993) 873]; etc.). A complementary approach focuses on some of the cognitive processes involved in patients' re-evaluation of their anomalous experiences and of their specific misinterpretations: distancing, objectivity, perspective, and self-correction. The Beck Cognitive Insight Scale (BCIS) was developed to evaluate patients' self-reflectiveness and their overconfidence in their interpretations of their experiences. A 15-item self-report questionnaire was subjected to a principle components analysis, yielding a 9-item self-reflectiveness subscale and a 6-item self-certainty subscale. A composite index of the BCIS reflecting cognitive insight was calculated by subtracting the score for the self-certainty scale from that of the self-reflectiveness scale. The scale demonstrated good convergent, discriminant, and construct validity: (a) the BCIS composite index showed a significant correlation with being aware of having a mental disorder on the Scale to Assess Unawareness of Mental Disorder (SUMD; Arch. Gen. Psychiatry 51 (1994) 826) and the self-reflectiveness subscale was significantly correlated with being aware of delusions on the SUMD, (b) the composite index score of the BCIS differentiated inpatients with psychotic diagnoses from inpatients without psychotic diagnoses, and (c) in a separate study, change scores on the BCIS were significantly correlated with change scores on positive and negative symptoms. The results provided tentative support for the validity of the BCIS. Suggestions were made for further investigation of the cognitive processes involved in identifying and correcting erroneous beliefs and misinterpretations.
    MeSH term(s) Adult ; Awareness ; Cognition Disorders/diagnosis ; Cognition Disorders/psychology ; Depressive Disorder/diagnosis ; Depressive Disorder/psychology ; Female ; Hospitalization ; Humans ; Male ; Personality Inventory/statistics & numerical data ; Principal Component Analysis ; Psychiatric Status Rating Scales/statistics & numerical data ; Psychometrics ; Psychotic Disorders/diagnosis ; Psychotic Disorders/psychology ; Reproducibility of Results ; Schizophrenia/diagnosis ; Schizophrenic Psychology
    Language English
    Publishing date 2004-06-01
    Publishing country Netherlands
    Document type Comparative Study ; Journal Article
    ZDB-ID 639422-x
    ISSN 1573-2509 ; 0920-9964
    ISSN (online) 1573-2509
    ISSN 0920-9964
    DOI 10.1016/S0920-9964(03)00189-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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