RESUMO
Eight patients with combat-induced chronic posttraumatic stress disorder (PTSD) receiving long-term alprazolam therapy for anxiety or depression (maximum dose of 2-9 mg/day for 1-5 years) had alprazolam therapy withdrawn. Most of the patients underwent gradual medication withdrawal. All patients had a prior history of alcohol abuse or benzodiazepine dependence. During withdrawal, all patients had severe reactions including anxiety, sleep disturbance, rage reactions, hyperalertness, increased nightmares, and intrusive thoughts; and 6 of the 8 patients had homicidal ideation. As a result of this report, the authors suggest that the potential for severe withdrawal reactions, even with gradual tapering, should be considered before prescribing alprazolam therapy for this group of patients.
Assuntos
Alprazolam/efeitos adversos , Distúrbios de Guerra/tratamento farmacológico , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Síndrome de Abstinência a Substâncias/etiologia , Adulto , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/psicologia , Benzodiazepinas , Distúrbios de Guerra/psicologia , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/psicologia , Homicídio , Humanos , Masculino , Fúria , Síndrome de Abstinência a Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/complicaçõesRESUMO
The dual diagnoses of alcoholism and antisocial personality are frequently associated with suicide attempts. A group of 94 alcoholics with antisocial personality were divided on the basis of a previous suicide attempt. A variety of symptoms, including depression, alcohol and drug abuse, conduct disorder, and violence were found more frequently in the suicide attempter group as reported on the structured interview. These emotional problems were additionally found to have an earlier onset. The results were consistent with the concept of secondary sociopathy and indicated that higher psychopathology may be associated with suicide behavior.
Assuntos
Alcoolismo/psicologia , Transtorno da Personalidade Antissocial/psicologia , Tentativa de Suicídio/psicologia , HumanosRESUMO
Alcoholics with and without previous suicide attempts were compared on a variety of clinical variables. Drug abuse and major depression especially if accompanied by crying spells, hopelessness, or seeking psychiatric help were found more frequently in the suicide attempter group. Additionally, total psychiatric symptoms were found to be higher in the suicide attempters in various categories including somatic, obsessive-compulsive, and total number of psychiatric symptoms reported on the structured interview. These results indicate that certain psychopathological symptoms are associated with suicide attempts in alcoholics and may be predictive of completed suicide.