Drug withdrawal syndrome

Singh AJ, Renzi FP. 1993. Drug withdrawal syndromes. In Viccellio P. Handbook of Medical Toxicology. Boston, MA Little Brown and Company, 631-635. 

Anti hypertensive drug withdrawal syndrome - Antihypertensive drug withdrawal syndrome may occur after discontinuation of antihypertensives. 

The authors commented that physicians should be more aware of drug withdrawal syndromes, even after limited periods of administration of sedative drugs. 

C. It may be used therapeutically or diagnostically for patients with suspected alcohol or sedative-hypnotic drug withdrawal syndrome. 

Dependence and withdrawal can occur with all of the stimulants. Cocaine is one of the most strongly reinforcing drugs in self-administration paradigms in animals and also has a psychological withdrawal syndrome. A typical pattern of withdrawal includes a ravenous appetite, exhaustion, and mental depression, which may last for several days after the drug is withdrawn. Because tolerance develops quickly, abusers may take large doses, compared with those used medically, for example, as anorexiants. 

Fadda F, Columbo G, Mosca E, et al Suppression by gamma-hydroxybutyric acid of ethanol withdrawal syndrome in rats. Alcohol Alcohol 24 447-451, 1989 Fine J, Finestone SC. Sensory disturbances following ketamine anesthesia recurrent hallucinations. Anesth Analg 52 428 30, 1973 Freese TE, Miotto K, Reback CJ The effects and consequences of selected club drugs. J Subst Abuse Treat 23 151—156, 2002... 

Uni 1ke other drugs of abuse, the diagnosis of PCP intoxication is often difficult because of the wide spectrum of clinical findings that occurs with this drug. PCP toxicity sometimes can be mistaken for delirium tremens, acute psychiatric illness, sedative/ hypnotic overdosage, amphetamine intoxication, or sedative/ hypnotic withdrawal syndromes. 

If it is necessary to use systemic corticosteroids for long-term control therapy, once-daily or every-other-day therapy should be used and repeated attempts should be made to decrease the dose or discontinue the drug. Withdrawal of chronic therapy may precipitate adrenal failure or unmask underlying inflammatory disorders such as Churg-Strauss syndrome. 

SSRIs are the drugs of choice for PD. All SSRIs have demonstrated effectiveness in controlled trials, with 60% to 80% of patients achieving a panic-free state.28,48,49 With similar efficacy reported and no trials comparing SSRIs with other SSRIs, selection generally is based on pharmacokinetics, drug interactions, side effects, and cost differences (see Chap. 35 for more discussion). The most common side effects of SSRIs include headaches, irritability, nausea and other gastrointestinal complaints, insomnia, sexual dysfunction, increased anxiety, drowsiness, and tremor.49 SSRIs should not be discontinued abruptly to avoid a withdrawal syndrome characterized by dysphoric mood, irritability, and agitation. 

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