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SUBSTANCE WITHDRAWAL SYNDROME --- SUBSTANCE WITHDRAWAL SYNDROME

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Nowadays, benzodiazepines are widely used for treatment of anxiety and insomnia. It’s essentially due to their effectiveness and lack of real alternative. Many people use it every day and become addicted. In regards to adverse effects and loss of long-term efficiency, currently use of I benzodiazepines is inadequate. Recent year studies have demonstrated the possibility of giving up with benzodiazepines successfully, including elderly. Ail studies agreed that gradual taper of benzodiazepine dose is the most effective withdrawal strategy. Furthermore psychological assistance may increase the chances of success. Since several years, information campaigns have been carried out in order to educate the general public and health professionals about overconsumption of benzodiazepines as well as to encourage a more critical and rational use of these drugs. Pharmacists should play an important role in education of patients on use of benzodiazepines. Unfortunately, they usually adopt a passive role and do not insist on the need for a limited time of treatment and opportunity for a schedule withdrawal En raison de leur efficacité pour combattre l’anxiété et l’insomnie et le peu de véritable alternative, l’usage des benzodiazépines est très répandu. De nombreux patients en consomment quotidiennement et deviennent dépendants. En considérant les effets secondaires possibles et le manque d’efficacité sur le long terme, on peut remettre en question l’utilisation que l’on fait à l’heure actuelle des benzodiazépines. Ces dernières années, des études ont démontré la possibilité, y compris chez les personnes âgées, d’arrêter avec succès les benzodiazépines, à condition de le faire progressivement. En effet, une diminution graduelle des doses est une des stratégies les plus efficaces. L’association avec une psychothérapie de type cognitivo-comportementale semble même en augmenter l’efficacité, Depuis quelques années, des campagnes d’informations sont menées par le SPF santé publique dans le but de sensibiliser le grand public ainsi que les professionnels de la santé à la surconsommation de benzodiazépines. Le but étant que les patients et les professionnels de la santé portent un regard critique sur la consommation des benzodiazépines et les utilisent de façon rationnelle. Le pharmacien occupe une place privilégiée pour sensibiliser les patients à la problématique des benzodiazépines. Malheureusement, il a encore trop souvent un rôle passif lors de la délivrance de benzodiazépines, en n’insistant que rarement sur la durée du traitement et la possibilité d’envisager un sevrage

Benzodiazepines --- Substance Withdrawal Syndrome --- Pharmacists

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Hypothesis: Aim of this working is to access the nutritional status of patients admitted for alcohol withdrawal, to identify the groups who are at risk of malnutrition according the alcohol pattern and to evaluate the correlation between anxiety and dietary intakes.Patients and Methods: Subjects evaluated were alcoholics patients admitted to the "Saint Luc" university hospital for alcohol withdrawal. Patients with a disease that can induce or exacerbate malnutrition other than alcoholism were excluded from this study. Finally, 127 alcoholics patients were analyzed according to the alcoholic pattern, alcohol types consumed and gender by SPSS Version 20.0 software.Results: We observed 83 subjects (65.35%) have their no alcohol energy intake less than 25 kcal/kg/day represented with 46 subjects (75.4%) are subjects wihich have their alcohol intake less than or equal to 12.5 kcal/kg/day against 37 subjects (56.1%) with alcohol intake above 12.5 kcal/kg/day. According gender, we observed 59 subjects (62.77%) of men and 24 subjects (72.73%) of women. Consequently, these subjects have low intakes of nutrients relative to Belgian dietary recommendations. In addition to low energy intake of these 83 subjects, 5 subjects (6.02 %) have low plasmatic levels of albumin, prealbumin and P-carotene which 4 have low IMC. Overall, our subjects presented moderates states of state anxiety (STAI-a), trait anxiety (STAY-b) and depression (Beck) according alcoholic pattern and gender. And, we also observed a significant negative relation between state anxiety and non alcoholics energy intakes (r= - 0,26; p-value < 0,05).Conclusion: whatever the alcoholic pattern or gender, we find that the risk of malnutrition is high among our subjects evalt.ated. This malnutrition risk is real for 6.02 % of the 83 subjects who had no alcohol energy intakee lower than 25 kcal/kg/day. This specific link observed between state anxiety (STA-a) and no alcohol energy intakes suggest a probable decrease of NPY but further studies are needed to evaluate the hypothesis of brain reward circuit involvement in the energy and food intakes during alcohol withdrawal.

Alcoholics --- Alcohol Withdrawal Seizures --- Weaning --- Nutrition Surveys

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Alcohol Withdrawal Delirium --- Mental Disorders. --- classification.

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SUBSTANCE DEPENDENCE --- NARCOTICS --- WITHDRAWAL --- ANESTHESIA, GENERAL --- SUBSTANCE DEPENDENCE --- NARCOTICS --- WITHDRAWAL --- ANESTHESIA, GENERAL