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How to Stop Antiepileptic Drugs
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Drug withdrawal may be a serious clinical problem. Aminoff and Simon reported that discontinuation or irregularity of AED regimen was a factor in 27 of 98 cases of status epilepticus (1). However, in some patients drugs had been stopped up to 8 weeks before status occurred, and in five of the patients abrupt withdrawal from alcohol may have been a contributing factor. The individual drugs implicated were not identified. Moreover, the relation of drug levels to status epilepticus is not always clear. For example, Mattson et al. reported that status occurred in two patients during a change in their regimen from eterobarb to phenobarbital therapy, even though PB levels did not fall (2). Withdrawal from the eterobarb itself may have been a factor, or the episodes of status epilepticus may have been unrelated to AED changes.
Hallucinogens
Published in G. Hussein Rassool, Alcohol and Drug Misuse, 2017
Excessive use of ketamine can lead to psychological dependence. When the user stops using the drug, withdrawal symptoms set in. Symptoms of withdrawal, especially cravings, may lead the user to more abuse of ketamine. The most common ketamine withdrawal symptoms include: agitation, confusion, depression with suicidal risk, psychosis, loss of motor skills, double vision, hearing loss, increased heart rate, rapid breathing, loss of coordination, insomnia, shakes, fatigue and cognitive impairment. Within 24 hours of discontinuing ketamine, acute withdrawal symptoms typically set in and may persist for two weeks, but begin to stabilise toward the two-week mark. However, how long the symptoms last is determined by the amount of drugs in the addict’s body, their tolerance level, how long they had been using the drug and if they have combined ketamine with other psychoactive substances.
Management of female androgenetic alopecia
Published in Pierre Bouhanna, Eric Bouhanna, The Alopecias, 2015
Bianca Maria Piraccini, Aurora Alessandrini
Treatments should be continued for at least 6 months before assessing efficacy. Dermoscopy allows better visualization of the initial hair thickening. Regular drug use is mandatory for maintaining results. Minoxidil interruption often produces an acute telogen effluvium that starts 3–4 months after discontinuation of the drug. Drug withdrawal leads to loss of all beneficial effects after 6 months.
An evaluation of relugolix/estradiol/norethindrone acetate for the treatment of heavy menstrual bleeding associated with uterine fibroids in premenopausal women
Published in Expert Opinion on Pharmacotherapy, 2022
Mohamed Ali, Hsin-Yuan Chen, Yi-Fen Chiang, Osama A Badary, Shih-Min Hsia, Ayman Al-Hendy
Novel nonpeptide orally active gonadotropin releasing hormone (GnRH)-receptor antagonists including elagolix, relugolix, and linzagolix are currently the most explored anti-UF hormonal therapy on daily use [8]. Elagolix has been explored in several phase 2 and 3 trials for its efficacy in controlling bleeding in premenopausal women with UFs [9–12] besides increasing number of articles discussing the beneficial role of elagolix in UF bleeding and increasing afflicted women quality of life are being published in literature [5,13–17]. Interestingly, recent study showed that even in 45% of patients, who were considered non responders in the pooled analysis of two phase 3, 6-month randomized clinical trials (Elaris UF-1 and UF-2), have had a clinically meaningful response to elagolix with add-back therapy because they met at least one of the objective bleeding criteria [18]. Therefore, elagolix was granted US Food and Drug Administration (FDA) approval in 2020 by the for the treatment UF-related bleeding as two doses per day regimen in combination with Addback therapy (ABT) of estradiol/norethindrone acetate (E2/NETA) to overcome side effects resulting from low estrogen levels, importantly decreased bone mineral density (BMD), for maximum 2 years utility [5]. Notably, relugolix, in combination with same ABT, gained FDA approval in 2021 as the first drug administered once-daily for managing UFs-related heavy menstrual bleeding (HMB) in premenopausal women, for up to years treatment length [5,19]. Yet, symptoms are expected to relapse following drug withdrawal.
Extended-release morphine sulfate and naltrexone hydrochloride (EMBEDA): naltrexone-associated withdrawal and abuse-related effects in patients with chronic pain and recreational opioid users
Published in Current Medical Research and Opinion, 2019
Beatrice Setnik, Kenneth W. Sommerville, Glenn C. Pixton, Lynn Webster
Across the five MSN studies in 1781 patients with chronic pain, a total of 13 patients experienced AEs reporting verbatim the term withdrawal or had AEs denoted by the investigator as withdrawal symptom AEs (study 111). In study 202, no reported AEs included the event withdrawal. In study 301, five patients had AEs related to withdrawal: one patient had “drug withdrawal syndrome” during the titration phase, three patients had “drug withdrawal syndrome” during the maintenance phase (two, placebo; one, MSN), and another patient reported “diarrhea (withdrawal symptoms)” coded to diarrhea, “vomiting (withdrawal symptoms)” coded to vomiting, and “restless legs at nighttime (withdrawal symptoms)” coded to restless legs syndrome after completing 12 weeks of the maintenance phase. In study 302, two patients experienced “drug withdrawal syndrome”. In study 4003, one patient experienced “drug withdrawal syndrome” 3 days after the MSN prescription was filled, and another patient experienced withdrawal 1 day after the MSN prescription was filled. In study 111, four patients taking intact MSN reported several “withdrawal symptom AEs”, a special assessment unique to this study.
Antidiarrheal activity of methanol extract of Sophora tonkinensis in mice and spasmolytic effect on smooth muscle contraction of isolated jejunum in rabbits
Published in Pharmaceutical Biology, 2019
Yangyou Li, Jing Li, Xin Liu, Jianwu Zhang, Xue Mei, Rudan Zheng, Wei Chen, Qian Zheng, Shangjie Zhong
Diarrhea is a common gastrointestinal disease with many differing causes. Diarrhea associated with irritable bowel syndrome (IBS) is one of the most common forms occurring in young adults, a disease which seriously affects quality of life and working conditions. IBS is characterized by abdominal pain or discomfort and is often accompanied by abnormal defecation. The disease is common, affecting 5–20% of the general population worldwide (Brandt et al. 2009; Liu and Hou 2011) and 4.6–6% of the population in China (Zhao et al. 2010; Zhang et al. 2014). At present, the pathogenesis of diarrheal-type IBS (IBS-D) remains unclear, with no effective western medicine having been found for the long-term treatment of IBS-D (Bian et al. 2015). It is easy to relapse after drug withdrawal, with serious side effects and with harm to the physical and mental health of the patient (Han et al. 2018). Therefore, looking for Chinese medicine for IBS treatment is a new research direction.