Reduction of aggression during benzodiazepine withdrawal: Effects of flumazenil

@article{Saxon2010ReductionOA,
  title={Reduction of aggression during benzodiazepine withdrawal: Effects of flumazenil},
  author={Lars Saxon and Stefan Borg and Arto J Hiltunen},
  journal={Pharmacology Biochemistry and Behavior},
  year={2010},
  volume={96},
  pages={148-151}
}
Pharmacological uses of flumazenil in benzodiazepine use disorders: a systematic review of limited data
TLDR
Although flumazenil shows promising efficacy in the management of benzodiazepine use disorders and withdrawal, more randomized control trials are required before a definitive recommendation can be made around its use.
Endogenous ligands of benzodiazepine binding site have inverse agonistic properties.
Benzodiazepines: Uses, Dangers, and Clinical Considerations.
TLDR
The dependence on BZDs generally leads to withdrawal symptoms, requiring careful tapering of the medication when prescribed, and many drugs have been tested as a treatment for withdrawal, with few proving efficacious in randomized control trials.
Pharmacological class interventions for benzodiazepine withdrawal discontinuation: a meta-analysis
TLDR
Even though it could not prove that the pharmacological classes of drugs analyzed for the clinical management of BZD withdrawal discontinuation were efficacious, the investigation showed that some of these classes have the potentiality to manage BzD withdrawal discontinueduation and clinically facilitate the process when it is necessary, relevant, and recommended based on established guidelines.
The problems of long-term treatment with benzodiazepines and related substances.
TLDR
Benzodiazepines are generally highly effective when first given, but they should generally be given only for strict indications and for a limited time, and if these drugs still need to be given beyond the short term, timely referral to a specialist is indicated and possibly also contact with the addiction aid system.
Substance-Use Disorders and Violence
TLDR
Because of the complex behavioural and medical toxicity issues associated with drug intake, raising awareness and education of healthcare professionals on drugs’ health harms, interventions, harm reduction techniques and referral pathways are here deemed of particular relevance.
Non-clinical toxicity of (+)-limonene epoxide and its physio-pharmacological properties on neurological disorders
TLDR
The compound inhibited the developing of pentylenetetrazol- and picrotoxin-induced seizures, decreased deaths, and reduced immobility times, suggesting antidepressant effects should be linked to serotonergic and/or adrenergic transmission.
Paradoxical and Bidirectional Drug Effects
TLDR
A compendium of multiple class effects and individual reactions, relevant mechanisms, and specific clinical toxicological considerations of antibiotics, immune modulators, antineoplastic drugs, and cardiovascular, CNS, dermal, endocrine, musculoskeletal, gastrointestinal, haematological, respiratory, and psychotropic agents is provided.
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Effects of flumazenil in the treatment of benzodiazepine withdrawal – a double-blind pilot study
TLDR
There was an overall difference between patients and controls, with patients scoring higher on negative and somatic items and lower on positive psychological items, and flumazenil reduced symptoms thought to be important in withdrawal in patients treated for benzodiazepine dependency.
A theory of benzodiazepine dependence that can explain whether flumazenil will enhance or reverse the phenomena
TLDR
A theory of benzodiazepine dependence that can account for anxiogenic responses on drug withdrawal and for flumazenil's bidirectional effects is proposed; central to this theory is the assumption that flumAZenil normalises the benzodiazine receptor, returning it to a baseline state.
Flumazenil in alcohol withdrawal: a double-blind placebo-controlled study.
TLDR
Results from 15 alcohol-dependent subjects in a double-blind placebo-controlled cross-over study showed that flumazenil was neither anxiolytic nor anxiogenic, although withdrawal scores were reduced during the course of the study.
Individual differences in aggressive responding to intravenous flumazenil administration in adult male parolees
TLDR
Investigation of the effects of acute administrations of flumazenil on aggressive responding in adult humans found that aggressive responses varied across subjects, and additional laboratory research is needed to better clarify the behavioural mechanisms by which BZD receptor antagonists modify human aggressive responding.
Efficacy of a Combination of Flumazenil and Gabapentin in the Treatment of Alcohol Dependence: Relationship to Alcohol Withdrawal Symptoms
TLDR
A differential response to FMZ/GBP treatment, depending on pretreatment AW status, is suggested that should be taken into account during future treatment trials.
Behavioral effects of flumazenil in the social conflict test in mice
TLDR
Flumazenil produced moderate anxiolytic-like behavioural changes and a slight anxiogenic-like effect in mice, which might be reflecting antagonism of corresponding endogenous BZR ligands.
The effects of the benzodiazepine antagonist Ro 15-1788 on psychophysiological performance and subjective measures in normal subjects
TLDR
Although there was no clear-cut dose-response relationship, the results suggested a predominance of benzodiazepine-like effects at the higher dose on physiological measures whilst the lower dose was observed to have greater effects on a number of behavioural and subjective dimensions.
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