MBRP has become an established treatment in the field of addiction, but implementing the program in an outpatient setting remains a challenge.

We investigated the feasibility of MBRP in an naturalistic outpatient setting and the effect of mindfulness on underlying factors of addiction.

All patients treated between 2015 and 2019 in the MBRP program at Brugmann University Hospital and Addiction Center Enaden were eligible to participate. Patients were asked to fill in a questionnaire about underlying factors of SUD in the domains of pleasure, emotion regulation, stress, relationship with others and relationship with oneself as well as the effect of the completed training on these factors.

Of the 147(74 F) recruited patients; 32 patients completed the questionnaire. The study population differed in terms of substance (mainly alcohol but also cocaine, cannabis, heroine) as well in their aims towards the substance (reduce, stop or maintaining abstinence). Participation of at least 4 of the 8 sessions was 63 % and overall satisfaction of patients was high. We found a positive effect of mindfulness on all of the underlying factors for SUD. Underlying factors of SUD, as well as the effect of mindfulness on these factors showed strong individual variation. The most frequently observed negative effect was acute craving; 1 patient became acute suicidal.

MBRP is feasible and has a clinical relevant impact on underlying factors of SUD. Negative effects were also observed and should be carefully monitored.

No significant relationships.

Effectiveness of buprenorphine (BUP) is moderated by medication misuse diversion and non-adherence, and poor retention and high cost. Contingency Managment has added benefit to BUP with Take-home doses as the most preferred reward by Opioid Use Disorder patients.

Examine the clinical effectiveness of a novel incentivised medication adherence and abstinence monitoring to enable contingent access to increasing BUP take-home doses.Explore associations with opioid use and retention. Contrast characteristics of polysubstance abusers (PSA) and response to BUP, with single opioid users.

Two-arm, pragmatic, 16-week outpatient RCT of BUP maintenance.Takehome doses were provided as stepped-approach upto 4-weeks contingent of abstinence (UDS) and adherence according to Therapeutic Drug Monitoring-TDM. Primary outcome and secondard outcomes were % negative UDS for opioids anx retention, respectively. -

Opioid % negative UDS was 76.7% (SD 25.0%) in I-AAM versus 63.5% (SD 34.7%) in TAU (13.3%; 95% [CI] 3.2%–23.3%; Cohen’s d 0.44; 95% CI 0.10–0.87). In I-AAM, 40 participants (57.1%) were retained versus 33 (46.4%) in TAU [OR: 1.54; 95% CI 0.79–2.98). PSA (73.7%, n=104) and carisprodol use increases non-fatal overdose (OR) 3.83, 95% CI 1.25 to 11.71) and 5.31, 95% CI 1.92 to 14.65], respectively. Opioid and non-opioid UDS are positively associated. BUP elimination rate (BUP-EL.R) predicts 26.5% to 65% of negative opioid UDS [Beta - 89.95, 95% CIl -154.20 to -25.70, R2 0.22]. Family enagement increases retention by 3-fold.

BUP + incentivised TDM for contingent access to increasing take-home doses increased abstinence. BUP-EL.R seems promising in BUP treatment precision and BUP is clinically valuable in polysubstance abusers.Engaging family enhances retention.

No significant relationships.

Today, a number of researchers consider the problem of addictive behavior as one of the most global problems for Kazakhstan and Russia. Some scientists consider CBT to be the most effective way to work with addictions. In our country there are no scientific works devoted to the study of addictive beliefs, so we decided to conduct such a study

The Objective of the study was to identify the characteristic addictive beliefs of drug addicts with different type of addiction: opioids and synthetic cathinones (designer drugs called “salts”, “bath salts”)

Questionnaire of addictive beliefs by A, Beck, questionnaire of beliefs about cravings by A. Beck and F. Wright, clinical interview. Descriptive statistics and chi-square test were used for data processing

People with opioid addiction are more likely to believe that their lives will become more depressive if they stop using drugs (p= 0.0347); that drug use is the only way to cope with pain in their life (p= 0.0347) and that they cannot cope with anxiety without drugs (p=0.009). Respondents who use synthetic psychostimulants endorse to believe that addiction is not a problrm for them (p= 0.0358).

Having categorized these beliefs in accordance with A. Beck’s classification, we came to the conclusion that “relief-oriented beliefs” are more typical for people who use opiates. The motive for use is often the desire to alleviate a negative emotional or physical state. For people using psychostimulants “salt”, “anticipatory beliefs” are more characteristic - the desire to experience euphoria and pleasant experiences

No significant relationships.

When speaking of behavioral addictions (especially to the Internet and social media), it is emphasized that it is not the environment that is the main contributor to addiction, but rather certain behaviors and personality traits.

The aim of this study was to assess the level of Internet and social media addiction on the example of Facebook with regard to psychological and social factors.

This survey-based study involved a group of women representing the female population in the West Pomeranian Voivodeship, Poland (N = 556). Research instruments were a self-developed questionnaire concerning sociodemographic data, the De Jong Gierveld Loneliness Scale, the Beck Depression Inventory, the Internet Addiction Test, and the Bergen Facebook Addiction Scale.

Age, depressive symptoms, loneliness were the variable contributing to Internet and Facebook addiction among the studied. Available studies confirm the results of their own research.

Depressive symptoms and dependence on the Internet and Facebook were more common among single women. In the employed women, we only observed higher levels of Internet and Facebook addiction. The level of dependence on the Internet and Facebook was higher among younger women. Loneliness correlated with Internet and Facebook addiction, and more severe depressive symptoms entailed higher levels of Internet and Facebook addiction.

No significant relationships.

There is a lack of evidence in the literature about the impact of offspring addiction and their parents’ mental health. Objective is to explore psychiatric disorders in parents of patients with substance dependence and their effect on the severity of their addiction.

To evaluate psychiatric disorders in parents of patients with substance dependence and their effect on the severity of their addiction.

This is a cross sectional study contained group (A) 150 patients diagnosed with substance dependence according to DSM-IV. Patients were recruited form Psychiatry and Addiction Hospital of Cairo University. Group (B) included one or both parents of the patients group. The Addiction Severity Index (ASI) was used for the patients.

In the patients group, mean age was 24.89 (±4.52). 96% of them were males 4% were females. In the parent group, mean age was 51.59 (±5.48). 84% of them were mothers 16 % were females. Patients group was associated with moderate degree of education (46.7%), 73.3% were single and 64% were unemployed. Anxiety disorders (80%) and depressive disorders (69.3%) were the most prevalent among parents group. ASI score was statistically significant in predicting the incidence of parents psychotic and schizoid disorders (100% sensitivity, 86.3% specificity, AUC=0.887, P value <0.0001).Besides we found a significant correlation between patients ASI scores and parents psychiatric disorder.

This result emphasizes the relation between patient substance use disorder and psychiatric disorder of their parents. Patients ASI score may be a possible measure for parents mental disorder. Further research is needed to validate our findings.

No significant relationships.

The anticonvulsant m-Cl-BHM is promising for the pathogenetically directed thrapy does not cause negative effects.

Investigation of the effect of m-Сl-BHM on “immunochemical homeostasis” in rats with experimental alcoholism.

m-Cl-BHM was injected at a dose of 100 mg/kg (1/20 LD50) for 5 and 30 days into the stomach of male Wistar rats who preferred alcohol according to the screening conditions and kept for 10 months. in free access to a 15% ethanol solution, which made up the group of “heavy drinkers” (HD). Phenobarbital was administered at a dose of 25 mg/kg (1/20 LD50).

The features of the monooxygenase system of cytochrome P450 of the liver and ECT in the lymphoid organs of rats were studied at different periods of administration of m-CL-BHM -5 and 30 days. to HD rats. m-CL-BHM has an inducing effect on the monooxygenase system of the liver, causes phase changes in the lymphoid organs and ECT. Long-term administration of m-CL-BHM caused a depletion of the cellular composition of lymphoid organs, a decrease in ECT of spleen cells and peritoneal exudate, these changes were less pronounced compared with phenobarbital. The activation of the immune system inversely regulates the production of enzymes of the cytochrome system, since the concentration of low molecular weight targets is sharply reduced with the help of antibodies. m-Cl-BHM metabolites conjugated to endogenous macromolecules form a full-fledged stimulus for the immune system.

Neuroimmune response to the introduction of m-CL-BHM is significant in behavioral disorders associated with alcoholism and the correction of this condition.

No significant relationships.

The use of psychoactive substances in pregnancy has a similar profile to the general population, in which ethyl alcohol and tobacco are the most widely used drugs, followed, to a much lesser extent, by marijuana and cocaine. Cocaine is a powerful stimulant of the Central Nervous System. Like other smokable cocaines, PBC is highly fat soluble and rapidly crosses the blood-brain barrier, causing maternal-fetal harm when consumed during pregnancy. Being its pathophysiological mechanism the vasoconstriction of uterine and fetal vessels. Obstetric complications related to this toxic mechanism of action include: increased risk of spontaneous abortion, premature detachment of the normal inserted placenta, and intrauterine growth restriction.

We present how was the management of a 26-year-old woman, polytoxic, unemployed, living in a “squatting house”, referred from the Gynecology and Obstetrics service to the Addictive Behavior Unit, due to fetal alterations seen in ultrasound follow-ups. Presenting the fetus: delayed intrauterine growth, and bilateral ventriculomegaly with dilation of the left ventricle.

We report this case to social services and we started doing a weekly poison check. Presenting positive controls for both: cannabis and cocaine.

Due to the physical, psychological and environmental situation of the patient, the withdrawal of custody of her child is being considered.

These types of cases must be treated in a multidisciplinary way, with awareness of the disease and the consequences of continuing to consume must be addressed.

No significant relationships.

The harmful use of alcohol is an important risk factor for the health of the population around the world. The incidence of alcohol dependence in women is increasing and both its consumption pattern and its consequences have unique characteristics.

To present a literature review focused on alcohol use disorder with a gender perspective.

Literature review.

- Women use to start using alcohol sooner than men and this seems to be a risk factor to become addicted. - Due to physiological and psychological factors women experience more negative health effects from excessive alcohol use than men and it occurs at lower levels of use. - Psychiatric comorbidity associated with alcohol abuse such as anxiety and depression is more common in women and this in turn worsens the alcohol use disorder. - Alcohol consumption increases the vulnerability of women on several levels, including an increased risk of physical abuse.

Alcohol abuse among women deserves special attention and a specific intervention focused on the gender perspective.

No significant relationships.

Since June 2018, multi-site overdose prevention education and naloxone distribution has been available in the County of Skåne, Sweden. Among the participants there are individuals who have used naloxone to reverse overdose on multiple occasions (three times or more). Situations of overdose management are characterized by different conditions which inevitably lead to different decisions and outcomes.

To investigate the complex interaction of individual, social, and environmental factors of opioid overdose management, how these overdose situations affect responders´ lives, what impact prior experiences may have on engagement in future overdose situations and if needs of support to deal with these situations are met.

Qualitative study employing semi-structured interviews with individuals trained at needle exchange programs within the region who have used naloxone on more than two occasions to reverse opioid overdose. Interviews will be conducted during Q4 2021 and analysed thematically during Q1 2022.

Preliminary clinical observations point to the ambivalence between positive consequences of empowerment and pride in saving lives, and negative feelings of prior decisions and the burden to engage in future overdoses, in addition to insufficient access to support when dealing with these negative consequences.

Not yet available.

No significant relationships.

Facebook use among Teenagers has become a very common phenomenon. Its use can resuly in Facebook addiction .

To estimate the prevalence of problematic Facebook use among a sample of school-going adolescents.

This is a cross-sectional and descriptive study carried out among 110 school-going adolescenthe at 2 state colleges in Sidi Bouzid. We used a pre-established self-questionnaire containing 2 parts: a part exploring the socio-demographic data of the adolescent and a psychometric part: Bergen Facebook addiction Scale.

Study participants had a mean age of 14.4 years with extremes of 12 to 17 years. The sex ratio (M / F) (46/64) of the participants was 0.71.In our population, 13 students (11.8%) were smokers. Two students (1.8%) consumed alcohol. Cannabis use was noted in only one student.The majority of students (102), or 92.7%, had been online for more than a year.The daily Facebook connection time was more than 4 hours for 20.9%. Boredom was the number one reason for logging into Facebook for 82 students (74.5%) followed by curiosity for 45 students (40.9%). Fifteen students (13.6%) were addicted to Facebook (score> 10 on the Bergen Addiction Scale.

Facebook can be a useful and interesting tool to maintain and develop a network of relationships and create new ones. Its problematic use or addiction to Facebook has become a new scourge of public health. Faced with the negative impact of this addiction, It would be necessary to rationalize this use.

No significant relationships.

Acute and chronic exposure to cannabis have been associated with neurocognitive deficits in executive function, including inhibitory control processes.

To research memory deficiency in the young consumers of cannabis in Tunisia.

this is a transversal descriptive study conducted during two months (January and February 2020). The research involved about 137 participants in the emergency department at the university hospital of Mahdia

In our study population, there was a noticeable male predominance of 71%. Hence, the age structure ranged between 18 years old and 35 years old. Among the latters, 65.9% were single, and 29.7% experienced school failure. In this sample, 23.2% had a psychiatric history. The average age of the first use of cannabis was between 18 and 25 years old in 70% of cases. Besides, a high percentage of association of other substances was found among cannabis users as follows: use of tobacco 74.6%, alcohol 72.5% ecstasy 41.3%, and cocaine 25.4%. The use of cannabis was considered as a means of indulgence for 66.7% of the study population, as an anxiolytic for 26.8%, and as a sedative for 23.9%. Additionally, the effect of cannabis use on working memory deficiency according to the functional impact assessment scale was: no deficiency in 19% of cannabis users, minimal in 34%, mild in 32%, moderate in 9%, fairly severe in 4%, very severe in 1%, and extreme in1% of cases.

The assumption of the effect of cannabis on memory and cognitive deficiency remains controversial and leads us to suggest further in-depth study of this subject.

No significant relationships.

The prevalence of substance use disorder has rapidly increased recently. It is believed that the occurrence of mental disorders is strongly associated with substance use.

To identify prevelance of different psychiatric mobidity & symptomatology as Comorbidity amon the diagnosed patients of Substance Use Disorder

This study was conducted from June till December 2021. A total of 486 PDUs were recruited for this study. A self-administered questionnaire was distributed among PDUs admitted at the Rehabilitation Centre during the period of the study. The questionnaire inquired about the demographic details of the PDUs, their substance history and the occurrence of any MDs.

The mean age of the PDUs was 25.9 + 6.0 years. A total of (95%) men and (5%) women reported their gender. There were single (74.7%), married (23.1%), divorced (1.4%) and separated (0.7%) PDUs. A large majority of the PDUs (n = 159, 55.6%) had been using different drugs for more than three years. The various MDs reported among the PDUs were delusion (n = 100, 35.2%); paranoia (n = 51, 17.8%); mania (n = 36, 12.6%); depression (n = 156, 54.5%); (n = 100, 35.2%); auditory hallucinations (n = 73, 25.7%); visual hallucinations (n = 106, 37.3%) and anxiety (n = 46, 16.2%). Among 164 cannabis users, hallucinations (n = 35, 21.3%; p = 0.04) was the only significant MD.

Delusion and paranoia were amongst the most highly prevalent MDs reported. The occurrence of auditory hallucinations, mania and paranoia were significantly associated with cannabis, heroin and cocaine use, respectively.

No significant relationships.

Online sports betting (OSB) is frequently associated with gambling disorder (GD). In Tunisia, no study on this has been done so far.

To detect GD in a population of Tunisian OSB players, and to identify its risk factors.

This was a cross-sectional study of 58 male OSB players in the city of Sfax. The GD was assessed by a questionnaire relating to the DSM-V criteria. Depression, anxiety and stress were assessed using the DASS scale, gambling motivations using the GMQ-F scale, and impulsivity using the UPPS-P scale.

The mean age was 37.4 ± 8.29 years. The prevalence of JAP was 53.4%. On univariate analysis, the factors associated with GD were university level of education, the practice of other gambling, daily gambling, gambling spending > 300 Dinars / month , gambling duration > 3 years, the frequency of winning >1 win /6months , the occurrence of a Big Win, total GMQ-F score, coping motivation , and financial motivation. In the multivariate study, GD risk factors were gambling spending > 300 Dinars / month (p = 0.011; ORa = 223.16), financial motivation (p = 0.022; ORa = 3.967), pathological stress (p = 0.036; ORa = 224.388) and inversely associated with the age at onset of gambling (p = 0.026; ORa = 0.751) and the UPPS score (p = 0.011; ORa = 0.6).

Our results push us to deepen our knowledge and our studies concerning this problem in our country and to reflect on the management and prevention measures.

No significant relationships.

Studies show that coping skills are factors in successful rehabilitation.

The research is aimed to study the drug users` perception of the current life situation and their coping strategies.

Patients at the Free Narcological Clinic in Azerbaijan (n=46; 37 men, 9 women, aged 18 to 59) participated in our study after 10-12 days (stage 1) of a rehabilitation program. We used a structured interview, projective drawings (“The image of change”, “My difficult life situation”), and a questionnaire, “Appraisal Criteria of the Difficulty of a Life Situation”. The control group consisted of 35 non-drug users. Content analysis and t-test were used.

While the majority of patients (77%) failed to describe any coping strategy they use in difficult life situations, all of them assessed their difficult life situation as under control—an outlook that was significantly more optimistic than the evaluation of the control group (р=0.009). The most frequently mentioned life goals were avoiding the problem (39%) and regaining health (37%). However, analysis of obstacles to achieving life goals shows that 49% of drug users mentioned no obstacles or indicated that “there are no obstacles”. Drug addiction as an obstacle is mentioned in only 4% of the responses; “environment of drug addicts” occurs as the main obstacle in 20%.

Drug users in stage 1 of the rehabilitation program have an unrealistic sense of control, few coping strategies, and do not perceive drug addiction as posing а serious obstacle to achieving their life goals. Funding: The study was funded by RFBR, project number 20-013-00838.

No significant relationships.

Although gaming addiction has received a great deal of attention from researchers, few studies have evaluated its effect on health related quality of life in adults

To study the relationship between gaming addiction and perceived health status

We conducted a cross-sectional, descriptive and analytical study.Data were collected using a self-administered questionnaire on social networks targeting adults between 18 and 40 years. We used the gaming addiction scale (GAS) in its validated Arabic short version. we also used the 36-Item Short Form Health Survey questionnaire (SF-36) in its validated Arabic version

One hundred and nine participants were included. The mean age was 29.6 ±10.3. Males accounted for 60.6% of the study population. A history of anxiety or depression was found in 4.6 % of participants and 3.6% had an organic affection .The mean GAS score was 13.11± 6.08. According to this scale, 25.7% were addicted gamers. We found a significant difference between the group of participants considered addicts and those who were not in the following items: vitality (p=0.002), mental health (p=0.004) and role limitation due to emotional health (p=0.05). We found a correlation between the GAS score and role limitation due to physical problems ( p= 0.41), role limitations due to emotional problems (p=0.004 ), vitality( p=0.005) and mental health ( p= 0.001).

Our data showed significantly lower health related quality of life related to higher exposure to games especially in the psychological health.In future researches, the effect of gaming addiction on other domains of quality of life can be investigated

No significant relationships.

Religiosity is among the factors that determine the doctor’s relationship with his addict patient and the empathy he should have.

To verify whether future doctors are aware of the addictogenic power of certain substances and certain behaviors and to study their perception of different addictions according to religiosity.

This was a cross-sectional study with interns and externs of the Sfax medical faculty, in November 2016, via an anonymous questionnaire.

141 students were included and 98,6% declared to be believers. The average age was 23 years. The sex ratio was 0.38. Alcoholism was the addiction most considered as a sin (87.9%), smoking 51.8%, hookah 45.4%, cannabis 78%, gambling 77.3%, internet addiction 16.3%, video game addiction 15.6%, work addiction 8.5%, and exercise addiction 5.7%. Female gender was more often correlated with perceived alcoholism, cannabis addiction, and gambling as sins (p = 0.002; p <0.001 and p = 0.043, respectively). Gambling was significantly more condemned by the participants who fasted (p <0.001). Prayer was significantly correlated with religious disapproval of addictions to tobacco, hookah, alcohol, cannabis and gambling (respectively p <0.001, p = 0.001, p <0.001 , p <0.001, p <0.001). Smoking, hookah and alcohol were significantly more perceived as sins by veiled women (respectively p = 0.011, p = 0.002, p = 0.040).

According to our study, most medical students have a religiously hostile attitude to many addictions. Improving medical training in addictology would allow them to adopt the necessary empathic attitude, without being judgmental.

No significant relationships.

Smoking is the leading cause of preventable death in the world. Studies have shown that the frequency of its use in schizophrenic patients is significantly higher than in the general population,which hinders both treatment strategies and the efficacy of antipsychotics.

The objectives of our study are to highlight the prevalence of smoking in this population,to assess their nicotine dependence as well as to support the difficulties of their management.

We conducted a cross-sectional study of 92 male patients, hospitalized at Ar-razi Hospital in Salé, using the Fagerström scale, associated with a questionnaire that included age, marital status, educational level, somatic comorbidities, current treatment, other substances used, withdrawal attempts, age of first cigarette, family history of smoking, and finally,number of cigarettes per day before and after psychiatric diagnosis.

All our patients were male,the average age was 31 years, 84.8% of our patients were single, 73.9% were without a profession, only 23.9% were under classic neuroleptics while 4.3% were under Clozapine, the most of our patients were also using Cannabis,52.2% attempted a withdrawal, with an average duration of 6 months.69.6% of our patients had a family history of smoking and only 21.7% had somatic comorbidities.The average daily consumption was 12 cigarettes per day before the onset of psychiatric symptoms, rising to 18 cigarettes per day after the psychiatric diagnosis.

The frequency of smoking in schizophrenic patients is high. Unfortunately, these patients remain poorly aware of the harms of smoking, hence the need to integrate a smoking control strategy into the management of schizophrenia.

No significant relationships.

The COVID-19 pandemic led governments to take a number of restrictive measures, which had an impact on the consumption of psychoactive substances among the world population.

The present study, carried out by the Addictology Center of Ar-razi Hospital in Salé, aimed to evaluate the behavior of addicted patients followed in ambulatory care, during the Covid-19 pandemic.

We conducted a cross-sectional study with 128 patients, through a questionnaire assessing sociodemographic factors, psychiatric history, type and quantity of substances used during the pandemic, and withdrawal attempts.

The primary substance used was tobacco, followed by Cannabis, alcohol, hypnotics, and then Cocaine.

63% of patients reported an increase in their consumption during the pandemic, 64% started new substances, mainly Cannabis, followed by organic solvents.

The monthly amount spent by our patients varied from 300 to 40,000 dhs/month, the source of this amount was legal in 92.2% of the cases, 43.8% had already been incarcerated or taken into custody as a result of this consumption.

78% of our patients had already tried to wean themselves off the drug, but only 39% were able to succeed.

The pandemic had a profound effect on the incidence of substance use.

Confining the population has indeed reduced the transmission of the virus, but it is far from harmless for the mind.

No significant relationships.

Alcohol withdrawal delirium is severe complication of alcohol withdrawal leading to high mortality. Early identification of severe course of psychosis and complications threatening the patient’s life is the most important problem in the treatment of these patients.

Under supervision were 690 men, dependent on alcohol, in the state of withdrawal with acute psychotic disorder (primary hospitalization in the framework of this study); the average age - (39,9 ± 3,4 years), the average age of alcohol abuse - (9,7 ± 1, 1 years). The patients were examined in a dynamics after a re-hospitalization after 5-7 years. This allowed us to verify the differential diagnostic approach to acute psychotic disorders in a state of abandonment, to investigate the impact of chronic acute psychotic disorders on the course of alcohol dependence, including the formation of deficits.

clinical, clinical and psychopathological, methods of quantified scales and mathematical statistics.

There were estimated factors influencing the severity of alcohol withdrawal with delirium: total amount of alcohol consumed per week, drunken alcoholics, persistent alcohol abuse, social disadaptation, cognitive impairment, psychological disorders, reducing the quality of alcohol consumed, food pattern characterized total calorie mostly due to alcohol, life trajectory, severe or chronic somatic diseases, rate of progression of alcohol dependence.

The severity of acute psychotic disorder in the state of alcohol withdrawal mostly depended situational factors such as the number of days of severe drinking before a psychotic disorder, the pattern of nutrition, the quality and quantity of alcohol consumed, the presence of acute somatic diseases.

No significant relationships.

We present the case of a 36-year-old male with chronic alcoholism who suffered Delirium Tremens and other complications during hospital admission and who recovered thanks to treatment with benzodiazepines and antiepileptics using a cross tapering strategy.

Presentation of a case and review of the available literature on the pharmacological treatment of alcohol withdrawal.

A 36-year-old man was hospitalised for extensive dermatological lesions suggestive of Pellagra. He acknowledged a daily consumption of six litres of beer, was homeless and had a poor and unvaried diet. After 48 hours, the patient began to present hyperreflexia, disorientation and delusions of harm and was diagnosed with Delirium Tremens.

The case was managed jointly by Internal Medicine and Psychiatry. High doses of Chlorazepate (up to 400 mg daily), Tiapride (up to 600 mg daily) and Thiamine (300 mg daily) were prescribed. After 5 days of treatment, the patient started to improve but severe pain appeared in the lower limbs suggestive of alcoholic neuropathy. Gradually the treatment was replaced by Pregabalin (up to a dose of 1200 mg daily) which was effective in calming the late withdrawal and partially controlling the lower limb pain.

Benzodiazepines remain the first-line agent for severe withdrawal, while some antiepileptic drugs have proven useful in mild-moderate withdrawal and relapse prevention. Switching to antiepileptic drugs during follow-up should be considered because of the lower risk of dependence and respiratory depression, as well as the positive effects on the “kindling” phenomenon.

No significant relationships.