Treatment of Diazepam Withdrawal Syndrome with Propranolol
Authors: Darrell R. Abernethy, David J. Greenblatt, Richard I. Shader
Journal: Annals of Internal Medicine (1981)

Brief Reports1 March 1981Treatment of Diazepam Withdrawal Syndrome with PropranololDARRELL R. ABERNETHY, M.D., Ph.D., DAVID J. GREENBLATT, M.D., RICHARD I. SHADER, M.D.DARRELL R. ABERNETHY, M.D., Ph.D.Search for more papers by this author, DAVID J. GREENBLATT, M.D.Search for more papers by this author, RICHARD I. SHADER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-94-3-354 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTrue physiologic addiction to diazepam has been reliably described in isolated cases by documentation of a physical withdrawal syndrome characterized by agitation, tachycardia, and diaphoresis and, rarely, hallucinations, psychosis, and seizures (1). Although usually occurring after prolonged use of high doses, in one case a withdrawal syndrome occurred after abrupt withdrawal of diazepam after long-term use in a usual therapeutic dose (2). The present report describes a case of diazepam withdrawal syndrome after long-term ingestion of extremely high doses. The case was documented and the patient effectively treated with propranolol.Plasma levels of diazepam and desmethyldiazepam, the biologically active demethylated...References1. GREENBLATTSHADER DR. Dependence, tolerance, and addiction to benzodiazepines: clinical and pharmacokinetic considerations. Drug Metab Rev. 1978;8:13-28. CrossrefMedlineGoogle Scholar2. WINOKURRICKELSGREENBLATTSNYDERSCHATZ AKDPN. Withdrawal reaction from long-term low-dosage administration of diazepam. Arch Gen Psychiatry. 1980;37:101-5. CrossrefMedlineGoogle Scholar3. GREENBLATT D. Simultaneous gas-chromatographic analysis for diazepam and its major metabolite, desmethyldiazepam, with use of double internal standardization. Clin Chem. 1978;24:1838-41. CrossrefMedlineGoogle Scholar4. GREENBLATTSHADERHARMATZFRANKEKOCH-WESER DRJKJ. Absorption rate, blood concentrations, and early response to oral chlordiazepoxide. Am J Psychiatry. 1977;134:559-62. CrossrefMedlineGoogle Scholar5. SMITHDEKIRMENJIANDAVIDCASPERGOSENFIELDTSAI RHJRLC. Blood level, mood and MHPG responses to diazepam in man. In: GOTTSCHALK LA, MERLIS S., eds. Pharmacokinetics of Psychoactive Drugs: Blood Levels and Clinical Response. Flushing, New York: Spectrum Publications; 1976: 141-56. Google Scholar6. GREENBLATTKOCH-WESER DJ. Clinical pharmacokinetics. N Engl J Med. 1975;293:702-5, 964-70. CrossrefMedlineGoogle Scholar7. SHADERGOODGREENBLATT RMD. Anxiety states and beta-adrenergic blockade. In: KLEIN DR, GITTELMAN-KLEIN R, eds. Progress in Psychiatric Drug Treatment. Vol. 2. New York: Brunner/Mazel, Publishers; 1976: 509-28. Google Scholar8. RUTHERFORDOKOKOTYRER DAP. Plasma concentration of diazepam and desmethyldiazepam during chronic diazepam therapy. Br J Clin Pharmacol. 1978;6:69-73. CrossrefMedlineGoogle Scholar9. GREENBLATTALLENHARMATZSHADER DMJR. Diazepam disposition determinants. Clin Pharmacol Ther. 1980;27:301-12. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New England Medical Center Hospital and Tufts University School of Medicine Boston, Massachusetts. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByApproach to Anxiety in the Medically IllBarbituriques et autres hypnotiques et sédatifsBarbiturates and Other Hypnotics and SedativesNeuropsychiatric Effects of Cardiovascular Drug TherapyMechanisms of Benzodiazepine Drug DependenceThe treatment of benzodiazepine dependenceAdjunctive treatment of benzodiazepine discontinuation syndromes: A reviewAnxietyTreatment of benzodiazepine withdrawal symptoms with carbamazepineBenzodiazepine dependence: detoxification under standardized conditionsAnxietyEvidence that the increased anxiety detected in the elevated plus-maze during chlordiazepoxide withdrawal is not due to enhanced noradrenergic activityBenzodiazepine dependence — aetiological factors, time course, consequences and withdrawal symptomatology: a study of five casesBenzodiazepine withdrawal: Overview and implications for the treatment of anxietyDépendance aux benzodiazépines et syndrome de sevrage. Revue de la littératureBenzodiazepine dependenceTreatment of benzodiazepine dependencePatterns of Benzodiazepine Abuse and DependenceSevere Withdrawal Syndrome after Substitution of a Short-Acting Benzodiazepine for a Long-Acting BenzodiazepineCurrent Status of BenzodiazepinesAnxietyBenzodiazpine withdrawal effectsBenzodiazepine Withdrawal Syndrome: A Literature Review and Evaluation 1 March 1981Volume 94, Issue 3Page: 354-355KeywordsBlood plasmaClinical pharmacologyDiazepamEpileptic seizuresHallucinationsHealth services researchIngestionResearch fundingTachycardia Issue Published: 1 March 1981 PDF DownloadLoading ...