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Psychotropic Use during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Chlordiazepoxide is a benzodiazepine tranquilizer that has less potency than diazepam on a milligram basis. It also has less anticonvulsant, muscle relaxant and sedative properties, but is effective in treating alcohol withdrawal. In several cohort studies, the frequency of congenital defects was not increased among more than 480 newborns whose mothers had first-trimester exposure to chlordiazepoxide (Crombie et al., 1975; Hartz et al., 1975; Heinonen et al., 1977; Kullander and Kallen, 1976a, 1976b). Two case-control studies reported no association between maternal use of this benzodiazepine in the first trimester and congenital defects (Bracken and Holford, 1981; Rothman et al., 1979). In contrast, in a small cohort study an association was reported between congenital malformations in 35 infants and maternal use of chlordiazepoxide in the first 42 days of gestation (Milkovich and van den Berg, 1974). However, there was no pattern to the anomalies observed.
The story of modern tranquilliser drugs
Published in Adam Doble, Ian L Martin, David Nutt, Calming the Brain: Benzodiazepines and related drugs from laboratory to clinic, 2020
Adam Doble, Ian L Martin, David Nutt
Chlordiazepoxide was then rapidly evaluated in clinical trials, first of all in schizophrenia. It was noted that, even though devoid of proper antipsychotic activity, chlordiazepoxide dramatically improved symptoms of anxiety in these patients. A subsequent study in what we would now call generalised anxiety disorder showed remarkable efficacy (Tobin and Lewis, 1960). The investigators concluded that ‘chlordiazepoxideconstitutes a most interesting development which makes possible successful treatment of patients with the aforementioned conditions (anxiety and tension states), who heretofore have been refractory to all other modalities of therapy’.
Drugs Affecting the Central Nervous System
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: The use of Chlordiazepoxide during the in 1st and 3rd Trimesters should be avoided because the pregnancy experience in humans, and the reproduction studies in animals have shown an increased risk of congenital abnormalities, neonatal flaccidity and withdrawal symptoms.
Overview of analytical methods for determining novel psychoactive substances, drugs and their metabolites in biological samples
Published in Critical Reviews in Toxicology, 2022
Jadwiga Musiał, Jakub Czarny, Renata Gadzała-Kopciuch
Yeter (2017) relied on the SPE method to isolate 162 psychoactive substances and drugs from the blood with a recovery rate of 4.2–122%. Higher recovery rates were reported for benzodiazepines. The lowest recovery rates were noted for chlordiazepoxide, methylecgonine, metronidazole, paracetamol, CP 47.497, HU 210, and JWH 018 N-5-hydroxypentyl at 5.4%, 7.4%, 4.2%, 5.9%, 5.8%, 6.7%, and 5.4%, respectively. The highest recovery rates were obtained for Δ9-THC (122%), 5-F-AKB-48-4-hydroxypenttyl (118.6%), ADB-Pinaca (118.3%), Metoprolol (112.2%), and Imipramine (114%). Swortwood et al. (2013) analyzed a significantly smaller number of cathinones and other designer drugs in the blood with recovery rates in the range of 67.3–128.5%. These results suggest that extraction losses can be significantly reduced by focusing on a specific group of compounds. The lowest recovery rates were reported for 2 C-T-4 (69.5%) and 2 C-T-7 (67.3%), which was attributed to the presence of sulfur in the structure of these compounds. Recovery rates in excess of 100% were attributed to possible losses during the drying and enrichment phase.
Effects of Multiple Detoxifications on Withdrawal Symptoms, Psychiatric Distress and Alcohol-Craving in Patients with an Alcohol Use Disorder
Published in Behavioral Medicine, 2021
Martha Ooms, Hendrik G. Roozen, Juul H. Willering, Wobbe P. Zijlstra, Ranne de Waart, Anna E. Goudriaan
The inpatient detoxification was focused on sustained alcohol abstinence. The previous number of detoxifications was M = 5.09 (SD = 2.86) for the ≥2 previous detoxifications (see Table 1 for detailed information on the group of <2 previous detoxifications). The patients’ medication dosage regimen was based on two protocols.38,39 More than 80% of the patients were medically supported during the withdrawal process. Withdrawal symptoms were in most cases treated with chlordiazepoxide with an average dose of 40 mg – 200 mg q.i.d. Consistent with the protocols, the dosage regimen was frequently tapered within a 7-day period, contingent on observed and self-reported symptoms. In general, after 7-10 days most of the withdrawal symptoms subsided. During the detoxification phase, 36.5% received additional anti-depressants (e.g. venlafaxine, paroxetine), 23.1% sleeping medication (e.g. temazepam, zoplicone), 9.6% benzodiazepines on a maintenance dose (e.g.oxazepam), and 7.7% anti-craving agents (e.g. naltrexone, acamprosate).
Evaluation of the appropriate use of a CIWA-Ar alcohol withdrawal protocol in the general hospital setting
Published in The American Journal of Drug and Alcohol Abuse, 2018
Amanda S. Eloma, Jason M. Tucciarone, Edmund M. Hayes, Brian D. Bronson
Out of 1912 encounters identified on a CIWA-Ar protocol, a total of 102 patients and 118 encounters were included. The quantity of administered benzodiazepines were converted to lorazepam equivalents (14), and comprised of symptom-triggered, fixed-dose, or off-protocol orders during the entire course of admission. Our AWS standard protocol utilizes scheduled and as needed (PRN) regimens of oral chlordiazepoxide and/or lorazepam in oral or parenteral administration; however, all benzodiazepines administered, including alprazolam, clonazepam, diazepam, temazepam, and zolpidem (a non-benzodiazepine gamma-aminobutyric acid-A receptor agonist) were reviewed. Route of medication administration was noted.