| Hyperammoneic encephalopathy, valproic acid, and benzodiazepine withdrawal: a case series. | |
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MedLine Citation:
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PMID: 20337505 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Benzodiazepine withdrawal is accompanied by a risk of seizures, delirium, and death. While a gradual outpatient taper off of benzodiazepines is the most commonly recommended method for discontinuation, acute inpatient detoxification and seizure prophylaxis may be necessary for some. Complications related to the use of valproic acid for seizure prophylaxis are presented. OBJECTIVES: The study's objectives are to highlight an uncommon and possibly unrecognized complication of valproic acid when used for seizure prophylaxis during acute inpatient detoxification from benzodiazepines in the context of current practice. METHODS: Case series. RESULTS: Three patients with hyperammoneic encephalopathy are described. CONCLUSIONS: Hyperammoneic encephalopathy can occur as a distinct entity separate from hepatotoxicity with the use of valproic acid and may be an unrecognized complication among patients receiving this drug during benzodiazepine detoxification. SCIENTIFIC SIGNIFICANCE: A previously unreported complication among the addiction patient population is reported. This underscores the need for a better evidence base regarding the prevention of seizures during acute benzodiazepine detoxification, particularly in terms of indications, safety, and efficacy. |
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Authors:
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Jacquelyn Starer; Grace Chang |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: The American journal of drug and alcohol abuse Volume: 36 ISSN: 1097-9891 ISO Abbreviation: Am J Drug Alcohol Abuse Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-26 Completed Date: 2010-06-14 Revised Date: 2011-08-25 |
Medline Journal Info:
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Nlm Unique ID: 7502510 Medline TA: Am J Drug Alcohol Abuse Country: England |
Other Details:
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Languages: eng Pagination: 98-101 Citation Subset: IM |
Affiliation:
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Faulkner Hospital Addiction Recovery Program, Boston, Massachusetts 02130, USA. jstarer@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Benzodiazepines
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adverse effects* Brain Diseases, Metabolic / chemically induced* Drug Administration Schedule Female GABA Agents / adverse effects, therapeutic use Humans Hyperammonemia / chemically induced* Male Middle Aged Substance Abuse Treatment Centers Substance Withdrawal Syndrome / drug therapy* Substance-Related Disorders / drug therapy Treatment Outcome Valproic Acid / adverse effects*, therapeutic use |
| Grant Support | |
ID/Acronym/Agency:
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K24 AA000289-09/AA/NIAAA NIH HHS; K24 AA00289/AA/NIAAA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/GABA Agents; 12794-10-4/Benzodiazepines; 99-66-1/Valproic Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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