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Query: UMLS:C0278080 (physical dependence)
 1,658 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clomethiazol (Distraneurin) has decisively improved our therapeutic possibilities in delirium tremens. Furthermore, it has acquired a certain degree of importance in the treatment of agitation and sleep disorders in geronto-psychiatric patients. In the meantime, owing to the fact that doctors have been too ready to prescribe it for indications other than those mentioned above, a level of abuse of this substance--which has the potential for both psychological and physical dependence--has reached a point at which its usefulness threatens to become eclipsed.
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PMID:[Indications for the use of chlormethiazole ]. 226 90

Clinically, patients with Delirium Tremens (DT) and acute alcohol hallucinosis (impending DT) appear excited with vivid false perception. Cerebral blood flow and eeg correspondingly point to hyperexcitability in the CNS during these conditions. Clinical trials with barbital treatment in alcohol withdrawal shows that the amount of drug and the drug plasma concentration is the same no matter whether the physical signs of withdrawal are accompanied by hallucinations and clouding of consciousness. The psychotic signs in DT and acute alcoholic hallucinosis develops after many years of alcoholism as does seizures. We hypothesize that physical withdrawal is determined by the degree of physical dependence developed during the most recent drinking period whereas the psychotic signs and seizures are due to a cumulated CNS hyperactivity developed over many years of repeated alcohol intoxication and withdrawal. Changes of electrolyte concentrations in plasma or CSF do not play an important role in the pathogenesis of DT and related clinical states except that changes in calcium and inorganic phosphate metabolism indirectly point to changes in membrane excitability. A new model for a study of rapidly repeated intoxication and withdrawal episodes in rats has shown that repetition of episodes augments the convulsive component of withdrawal whereas the non-convulsive signs are dependent on the most recent episode only. The augmentation of the convulsive component correlates with regional differences in brain glucose consumption. Furthermore, synaptic proteins and acidic phospholipids may be involved in the development of CNS hyperexcitability during alcohol withdrawal. In conclusion both clinical and experimental studies indicate that severe alcohol withdrawal reactions may consist of two components: 1) Physical withdrawal signs determined by recent physical dependence. 2) A long term cumulated CNS hyperexcitability relating to seizures and psychotic signs during withdrawal. This state is elicited by alcohol withdrawal but it represents a cumulated and permanent or long lasting CNS dysfunction in alcoholics. The precise biochemical/pathophysiological mechanisms for the development of the two-component dysfunction still remain to be clarified in detail.
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PMID:Delirium tremens and related clinical states: psychopathology, cerebral pathophysiology and psychochemistry: a two-component hypothesis concerning etiology and pathogenesis. 306 44

During the last years, there have been more and more observations of physical dependence on the benzodiazepines. This paper emphasizes the seriousness of this syndrome, its similarity with delirium tremens and its optimal treatment by high doses of benzodiazepines. This article shows also the misuse of drugs lowering the epileptogenic threshold and suggests in replacement the peranaesthesic administration of benzodiazepines or barbiturates. Finally the treatment should be started with a gradual and slow withdrawal so as to avoid undesirable neurological signs.
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PMID:[Physical dependence on benzodiazepines in traumatology]. 614 13

The folic acid (FA) levels in serum and cerebrospinal fluid (CSF) of 39 chronic alcoholics, 15 methamphetamine addicts and 18 control subjects were determined using the technique of Lactobacillus casei assay. Twelve of the 39 alcoholics developed delirium tremens (DT) after determination of the FA level. The serum FA level of the alcoholics with DT was significantly lower than that of the controls, and showed a tendency to be lower than in the alcoholics without DT. The CSF FA of the DT group was significantly lower than that of the control group and of the alcoholics without DT. In the methamphetamine addicts, although the serum FA was significantly lower than that of the controls, the CSF FA remained unchanged. All the methamphetamine addicts demonstrated psychological dependence and tolerance development as did the alcoholics, but they did not show any physical dependence. From these results, a mechanism underlying the development of symptoms of physical dependence such as DT was discussed in relation to the CSF FA.
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PMID:Folic acid in serum and cerebrospinal fluid of chronic alcoholics and methamphetamine addicts. 724 28

The alcoholic withdrawal syndrome (AWS) arises variably within hours following the hospitalization of an alcohol dependent patient. Delay usually observed between admission and the first symptoms depends above all on alcohol serum level concentration at arrival and on the degree of severity of physical dependence. The case reported here describes the very late onset severe alcoholic withdrawal syndrome observed in a 57-year-old alcohol dependent patient hospitalized for leg trauma and operated within hours followed admission. The first symptoms of AWS appeared only the 4-th day after hospitalization and the patient quickly developed a clinical state of delirium tremens. Delay in the onset of this AWS is discussed.
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PMID:[Late-onset alcohol withdrawal syndrome]. 1110 41