Flumazenil-precipitated panic and dysphoria in patients dependent on benzodiazepines: A possible aid to abstinence

Journal of Psychopharmacology

Volumn 10, Issue 2, 1996, Pages 89-97

  Harrison Read, P E ^a   Tyrer, P ^a   Lawson, C ^b   Lack, S ^a   Fernandes, C ^c   File, S E ^c  

^a ST CHARLES HOSPITAL   (United Kingdom)

^b NORTHERN GENERAL HOSPITAL   (United Kingdom)

^c GUY S HOSPITAL   (United Kingdom)

Author keywords

Benzodiazepine withdrawal; Flumazenil; Flumazenil induced panic; Long term benzodiazepine users

Indexed keywords

BENZODIAZEPINE DERIVATIVE; BENZODIAZEPINE RECEPTOR BLOCKING AGENT; FLUMAZENIL;

ADULT; ARTICLE; BLOOD PRESSURE; CLINICAL ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DOUBLE BLIND PROCEDURE; DRUG DEPENDENCE; DYSPHORIA; FEMALE; HUMAN; INTRAVENOUS DRUG ADMINISTRATION; MALE; PANIC; PRIORITY JOURNAL; PROVOCATION TEST; PULSE RATE; RANDOMIZED CONTROLLED TRIAL; SINGLE BLIND PROCEDURE; WITHDRAWAL SYNDROME;

EID: 0029892572     PISSN: 02698811     EISSN: None     Source Type: Journal    
DOI: 10.1177/026988119601000201     Document Type: Article

References (26)

1. Andrews N A, File S E (1993) Increased 5-HT release mediates the anxiogenic response during benzodiazepine withdrawal: a review of supporting neurochemical and behavioural evidence. Psychopharmacology 112: 21-25
2. Baldwin H A, Hitchcott P K, File S E (1990) The use of flumazenil in prevention of diazepam dependence in the rat. Human Psychopharmacol 5: 57-61
3. Bernik M A, Gorenstein C, Gentil V (1991) Flumazenil precipitated withdrawal symptoms in chronic users of therapeutic doses of diazepam. J Psychopharmacol 5: 215-219
4. Bond A, Lader M H (1974) The use of analogue scales in rating subjecting feelings. Br J Med Psychol 47: 211-288
5. Curtis G, Nesse R, Buxton M, Wright J, Lippman D (1976) Neuroendocrine response to stress in phobic patients. Comp Psychiatr 17: 153-160
6. File S E, Hitchcott P K (1990) A theory of benzodiazepine dependence that can explain whether flumazenil will enhance or reverse the phenomena. Psychopharmacology 101: 525-532
7. Gentil V, Tavares S, Gorenstein C, Mathias L, Gronich G, Singer J (1990) Acute reversal of flunitrazepam effects by Ro 15-1788 and Ro 15-3505: inverse agonism, tolerance, and rebound. Psychopharmacology 100: 54-59
8. Higgitt A, Lader M H, Fonagy P (1986) The effects of the benzodiazepine antagonist R015-1788 on psychophysiological performance and subjective measures in normal subjects. Psychopharmacology 89: 395-403
9. Higgitt A, Fonagy P, Toone B, Shine P (1990) The prolonged benzodiazepine withdrawal syndrome: anxiety or hysteria? Acta Psychiatr Scand 82: 165-168
10. Lader M H, Morton S V (1992) A pilot study of the effects of flumazenil on symptoms persisting after benzodiazepine withdrawal. J Psychopharmacol 6: 357-363
11. Murphy B E P (1967) Some studies of the protein binding of steroids and their application to the routine micro and ultramicro measurement of various steroids in body fluids by competitive protein-binding radioassay. J Clin Endocrinol 27: 973-990
12. Nutt DJ (1990) Benzodiazepine dependence: new insights from basic research. In Hindmarch I, Beaumont G, Brandon S, Leonard B E (eds), Benzodiazepines: current concepts. John Wiley, Chichester, pp. 19-41
13. Nutt D J, Glue P, Lawson C, Wilson S (1990) Flumazenil provocation of panic attacks. Arch Gen Psychiatr 47: 917-925
14. Petursson H, Lader M (1984) Dependence on tranquillizers. Maudsley Monographs 28, Oxford University Press, Oxford
15. Pocock S J (1983) Clinical trials: a practical approach. John Wiley, Chichester
16. Rose R M (1984) Overview of endocrinologyof stress. In Brown G M, Koslow S H (eds), Neuroendocrinology and psychiatric disorders. Raven Press, New York, pp.95-122
17. Roy-Byrne P P, Uhde T W, Post R M (1986) The corticotrophin-releasing hormone stimulation test in patients with panic disorders. Am J Psychiatr 143: 896-899
18. Tyrer P (1991a) The benzodiazepine post-withdrawal syndrome. Stress Med 7: 1-2
19. Tyrer P (1991b) The nocebo effect - poorly known but getting stronger. In Dukes M N G, Aronson J K (eds), Side effects of drugs annual 15. Elsevier, Amsterdam, pp. 19-25
20. Tyrer P (1992) Qui devient dependant des benzodiazepines? In Venisse J L (ed.), Les nouvelles addictions. Masson, Paris, pp. 14-147
21. Tyrer P, Alexander J (1979) Classification of personality disorder. Br J Psychiatr 135: 163-167
22. Tyrer P, Rutherford D, Huggett T (1981) Benzodiazepine withdrawal symptoms and propranolol. Lancet i: 520-522
23. Tyrer P, Owen R, Dawlings S (1983) Gradual withdrawal of diazepam after long-term therapy. Lancet i: 1402-1406
24. Tyrer P, Murphy S, Riley P (1990) The benzodiazepine withdrawal symptom questionnaire. J Affective Disor 19: 53-61
25. Woods S W, Charney D S, McPherson C A, Gradman A H, Heninger G R (1987) Situational panic attacks: behavioural, physiologic, and biochemical characterisation. Arch Gen Psychiatr 44: 365-375
26. Woods S W, Charney D S, Silver J M, Krystal J H, Heninger G R (1991) Behavioral, biochemical, and cardiovascular responses to the benzodiazepine receptor antagonist flumazenil in panic disorder. Psychiatr Res 36:115-127