Prazepam 10mg tablets

Introduction Sleep disturbances are a frequent and disabling symptom of pregabalin withdrawal and represent a major risk factor for relapse. In the absence of specific therapeutic recommendations, various pharmacological strategies are used in clinical practice to improve withdrawal-related comfort. Objective This study aims to compare the effects of amitriptyline and prazepam on sleep quality in patients with pregabalin use disorder. Materials and Methods This was an open-label comparative study including 40 patients managed in an addiction medicine unit. Patients were divided into two groups receiving either amitriptyline or prazepam as part of a medically supervised withdrawal program. Sleep quality was assessed at baseline and at day 30 using the Pittsburgh Sleep Quality Index (PSQI). A comparative statistical analysis was performed, with the type I error rate (α) set at 5% (p < 0.05). Results A significant improvement in the global PSQI score was observed in both groups after 30 days of treatment. No statistically significant difference was found between the two groups regarding the global PSQI score. However, sleep onset latency was significantly shorter in patients treated with amitriptyline. Conclusion Both amitriptyline and prazepam appear to be effective options for improving sleep quality during pregabalin withdrawal. Amitriptyline may represent a valuable non-benzodiazepine alternative, particularly in patients with predominant sleep-onset insomnia. Larger-scale studies are needed to confirm these findings.

Abstract licence: CC BY

IntroductionIn France, the consumption of benzodiazepines (BZD) remains significant despite Haute autorité de santé (French National Authority of Health-HAS) recommendations. Various strategies are recommended: gradual dosage reduction of the BZD consumed or switch to diazepam in certain situations. Prazepam may also be an interesting molecule (long half-life, oral solution, less risk of abuse than diazepam). The aim of this study is to describe the efficacy, adverse events and feasibility of a BZD withdrawal program with prazepam.Materials and methodsData were collected retrospectively among patients hospitalized at the Saint Barnabé clinic in 2022, which had a prescription of prazepam for withdrawal purposes. Withdrawal was considered successful at discharge if the initial prazepam dosage was reduced by more than 50 %, or if prazepam was stopped.ResultsMost of the 86 patients had psychiatric or addictive comorbidities. Among them, 55 % had been using BZDs for over a year, 36 % consumed at least two BZDs, and 15 % took doses exceeding authorized indications. At discharge (median of 42 days), 29 % of patients were fully withdrawn, and 33 % had reduced their initial prazepam dosage by more than 50 %. The protocol was adapted in 38 % of patients, and 27 % experienced withdrawal symptoms. Several factors were significantly associated with partially successful or no success: presence of personality disorder, hospitalization in a context of cocaine use disorder, signs of withdrawal and protocol adaptation.DiscussionThis study highlights the utility of prazepam in BZD withdrawal among a population at high risk for complicated withdrawal. The occurrence of clinical symptoms and protocol adjustments emphasize the importance of individualized management with regular medical reassessment.

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PurposeBenzodiazepines (BZD), Z-drugs (ZD), and opioids share a high risk of abuse. This study assessed and characterised adverse events (AEs) related to BDZ, ZD, and opioids leading to emergency department (ED) visits in the Italian setting.MethodsED accesses related to BDZ, ZD, and/or opioids were analysed from the MEREAFaPS database. Information on AEs, suspected and concomitant medications was retrieved. Multivariate logistic regression was used to estimate the reporting odds ratios (RORs) of hospitalisation according to the different treatments.ResultsA total of 5,970 pharmacovigilance reports involving BZD/ZD (n = 3,106), opioids (n = 2,767), or their combination (n = 97) were analysed. Compared to opioids, patients with BZD/ZD-related AEs were often younger (51 vs 64 years), more frequently presented 2+ suspected medications (13 vs 3%), and often had a history of abuse (4%). Twenty-three percent of BZD/ZD-related AEs were related to drug abuse (vs 2% of opioid-related ones) and frequently required patient hospitalisation (52% vs 24%), despite the significantly lower clinical complexity of these patients as compared to those on opioids. An increased risk of hospitalisation was found for flurazepam (ROR 1.62; 95% CI, 1.18-2.22), prazepam (2.66; 1.05-6.70), lorazepam (1.26; 1.07-1.49), and morphine (1.76; 1.11-2.79).ConclusionsThese results indicate that, in Italy, the inappropriate use of BZD/ZD is a relevant heath issue, often leading to serious AEs requiring patients' ED visits and hospitalisation, especially in young women and patients with a history of substance abuse.

Abstract licence: CC BY