Ehab Sayed Ramadan
Tanta University, Egypt
Ehab Sayed Ramadan completed MD and PhD from Faculty of Medicine Tanta University, Egypt. He is currently working as a Professor in Psychiatry and Psychology Faculty of Medicine, Tanta University, Egypt. He has sixteen publications in scientific journals. He worked as Director of Neuroscience University Center- Tanta, Egypt, from 9-2008 till 31-6-2010 and Consultant and Head of Neuropsychiatry Department Saudi German Hospital, KSA (from 2000 – 2006). He has experiences in clinical, educational and research work in the fields of psychiatry & psychology at faculties of Medicine, Nursing, and Arts.
Benzodiazepines are among the most common drugs of abuse in Egypt. The severe suffering during withdrawal of benzodiazepines following long term use; magnifies the need to develop treatment strategies for discontinuing these medications. The study aimed to evaluate different detoxification procedures that have been followed to manage benzodiazepines dependence and to assess their efficiency in controlling withdrawal symptoms and relapse rates. This study had been conducted in the center of Psychiatry, Neurology and Neurosurgery, Faculty of Medicine, Tanta University, Egypt. It lasted for 45 days and was divided into three phases; pretreatment phase (7 days), detoxification phase (8 days) and follow-up phase (30 days). Three different methods of detoxification of benzodiazepines dependence were applied during the detoxification phase and included 1) Slow flumazenil infusion (1 mg/500ml saline twice daily) as the main line of treatment with low doses of oxazepam given orally during the first three nights of detoxification phase 2) using oxazepam gradual tapering and 3) abrupt discontinuation of benzodiazepines with symptomatic treatment. Withdrawal symptoms were assessed by psychometric scales BWSQ, HAM-A, HAM-D scores and craving was assessed by VAS scores emerged in the three studied groups during the detoxification phase. The study revealed that flumazenil infusion with low doses of oxazepam was associated with the least intensity of withdrawal symptoms and craving. Also, relapse rates decreased in patients treated with flumazenil than those treated by oxazepam tapering or abrupt discontinuation with symptomatic treatment. It can be concluded that slow flumazenil infusion with low doses of oxazepam appeared to be more effective in controlling withdrawal symptoms, reducing craving and relapse rate after benzodiazepine discontinuation than oxazepam tapering or abrupt discontinuation with symptomatic treatment.
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