Case Report: Buprenorphine Induction Using Transdermal Buprenorphine in a Veteran With Opioid Use Disorder and Psychosis, Managing Precipitated Withdrawal
| Autor: | Kathryn R. Kinasz, Ellen Herbst, Raj K. Kalapatapu |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Psychosis
medicine.medical_specialty medicine.drug_class 03 medical and health sciences 0302 clinical medicine Pharmacotherapy medicine Humans 030212 general & internal medicine Intensive care medicine Veterans Benzodiazepine business.industry Public Health Environmental and Occupational Health Opioid use disorder General Medicine medicine.disease Opioid-Related Disorders Comorbidity Buprenorphine Substance Withdrawal Syndrome Opioid Psychotic Disorders business 030217 neurology & neurosurgery Methadone medicine.drug |
| Zdroj: | Military medicine. 185(9-10) |
| ISSN: | 1930-613X |
| Popis: | Buprenorphine induction can lead to precipitated opioid withdrawal, even when using novel techniques such as transdermal buprenorphine. Involuntary limb movements are a distressing symptom of precipitated withdrawal that can be difficult to treat. We report a case of a military veteran transitioning from methadone to buprenorphine for the treatment of opioid use disorder (OUD) using small doses of transdermal buprenorphine. Herein, we review the literature associated with opioid withdrawal-related restlessness. Despite the known risk of concurrent benzodiazepine and buprenorphine administration, including decreased respiratory rate and death, we present a clinical presentation in which this medication combination may be necessary while under medical supervision. We suggest a stepwise algorithm for pharmacotherapy in patients experiencing involuntary limb movements associated with precipitated withdrawal. To safeguard the success of medication-assisted treatment (MAT) for opioid addiction, clinicians should be aware of potential clinical challenges when managing precipitated opioid withdrawal in patients with complex psychiatric comorbidities. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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