Nový přístup k detoxikaci pacientů závislých na benzodiazepinech a Z-lécích pro snížení psychogenních komplikací

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Autoři: Kateřina Kubová; Aleš Franc; Jakub Vysloužil; Jan Šaloun; David Vetchý
Vyšlo v časopise: Čes. slov. Farm., 2019; 68, 139-147
Kategorie: Přehledy a odborná sdělení

Souhrn

Benzodiazepiny (BZDs) a Z-hypnotika jsou silně návykové látky, které působí na identické GABA receptory. Detoxifikace by měla být dlouhodobá a postupná, obvykle s využitím dlouhodobě působícího BZD (diazepamu). Zatím však neexistuje žádný vhodný komerčně dostupný produkt s potřebným nízkým obsahem diazepamu. Tento přehledový článek popisuje specifické farmakologické aspekty a srovnání jednotlivých BZDs ve vztahu k jejich účinkům a návykovosti. Úspěch léčby souvisí s komfortem pacienta během procesu vysazování léku. Pacienti se obvykle obávají přechodu na vhodnější dlouhodobě působící BZD (diazepam) a během vysazování mají obavy z abstinenčních příznaků. Tyto překážky by bylo možné překonat individualizovanou detoxifikací podle již publikovaných léčebných režimů. K dispozici je třeba mít lékovou formu s velmi přesnými dávkami diazepamu, což by umožnilo dlouhodobé postupné snižování dávky s možnou přísadou adjuvantních léčiv. Snížení dávky přitom nemění vnější vzhled lékové formy a pacient by mohl být léčen až do fáze podávání placeba. Individuálně připravená léková forma s odlišným a přesným obsahem diazepamu může být použita pro pohodlnou detoxifikaci a může také eliminovat psychogenní stres při přechodu z původního léčiva na diazepam a při snižování dávky v průběhu vysazování.

Klíčová slova:

benzodiazepiny – Z-hypnotika – závislost – vysazování – snižování dávky – detoxifikace

Zdroje

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