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The predominant neurological symptoms are seizures and altered levels of consciousness, ranging from somnolence to coma. Seizures are particularly notable due to tramadol's lowering of the seizure threshold, occurring in approximately half of acute poisoning cases. [43] Patients often exhibit tachycardia and mild hypertension. Gastrointestinal ...
A protracted withdrawal syndrome can occur with symptoms persisting for months to years after cessation of substance use. Benzodiazepines, opioids, alcohol, and any other drug may induce prolonged withdrawal and have similar effects, with symptoms sometimes persisting for years after cessation of use. Psychosis including severe anxiety and ...
Medications that lower seizure threshold include the antidepressant and nicotinic antagonist bupropion, the atypical opioid analgesics tramadol and tapentadol, reserpine, [1] theophylline, [2] antibiotics (fluoroquinolones, imipenem, penicillins, cephalosporins, metronidazole, isoniazid) and volatile anesthetics. So can other factors, including:
[67] [78] [79] [80] Some antipsychotic agents may be riskier than others during withdrawal, especially clozapine, olanzapine or low potency phenothiazines (e.g., chlorpromazine), as they lower the seizure threshold and can worsen withdrawal effects; if used, extreme caution is required. [81]
Individuals who have had more withdrawal episodes are at an increased risk of very severe withdrawal symptoms, up to and including seizures and death. Long-term activation of the GABA receptor by sedative–hypnotic drugs causes chronic GABA receptor downregulation as well as glutamate overactivity, which can lead to drug and neurotransmitter ...
A study in 2000 found that long-term benzodiazepine therapy does not result in brain abnormalities. [75] Withdrawal from high-dose use of nitrazepam anecdotally was alleged in 2001 to have caused severe shock of the whole brain with diffuse slow activity on EEG in one patient after 25 years of use. After withdrawal, abnormalities in hypofrontal ...
Seventy-four percent were using Suboxone to ease withdrawal symptoms while sixty-four percent were using it because they couldn’t afford drug treatment. The researchers noted: “Common reasons given for not being currently enrolled in a buprenorphine/naloxone program included cost and unavailability of prescribing physicians.”
Some medicinal and recreational drugs can dose-dependently precipitate seizures in withdrawal, especially when withdrawing from high doses and/or chronic use. Examples include drugs that affect GABAergic and/or glutamatergic systems, such as alcohol (see alcohol withdrawal), [19] benzodiazepines, barbiturates, and anesthetics, among others.