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withdrawal

MedGen UID:
442895
•Concept ID:
C2825032
•
Mental or Behavioral Dysfunction
Synonym: Withdrawal

Definition

A social or emotional detachment, pathological retreat from objective reality, interpersonal contact and social involvement, as in some forms of schizophrenia, depression, or schizoid, avoidant, or schizotypal personality disorders. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVwithdrawal

Professional guidelines

PubMed

2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility.
Smith HAB, Besunder JB, Betters KA, Johnson PN, Srinivasan V, Stormorken A, Farrington E, Golianu B, Godshall AJ, Acinelli L, Almgren C, Bailey CH, Boyd JM, Cisco MJ, Damian M, deAlmeida ML, Fehr J, Fenton KE, Gilliland F, Grant MJC, Howell J, Ruggles CA, Simone S, Su F, Sullivan JE, Tegtmeyer K, Traube C, Williams S, Berkenbosch JW
Pediatr Crit Care Med 2022 Feb 1;23(2):e74-e110. doi: 10.1097/PCC.0000000000002873. PMID: 35119438
Clinical management of cannabis withdrawal.
Connor JP, Stjepanović D, Budney AJ, Le Foll B, Hall WD
Addiction 2022 Jul;117(7):2075-2095. Epub 2022 Jan 10 doi: 10.1111/add.15743. PMID: 34791767Free PMC Article
Clinical management of the alcohol withdrawal syndrome.
Day E, Daly C
Addiction 2022 Mar;117(3):804-814. Epub 2021 Aug 22 doi: 10.1111/add.15647. PMID: 34288186

Recent clinical studies

Etiology

Clinical Management of Opioid Withdrawal.
Torres-Lockhart KE, Lu TY, Weimer MB, Stein MR, Cunningham CO
Addiction 2022 Sep;117(9):2540-2550. Epub 2022 Feb 22 doi: 10.1111/add.15818. PMID: 35112746
Alcohol Withdrawal Syndrome: Outpatient Management.
Tiglao SM, Meisenheimer ES, Oh RC
Am Fam Physician 2021 Sep 1;104(3):253-262. PMID: 34523874
Alcohol Withdrawal Syndrome in Neurocritical Care Unit: Assessment and Treatment Challenges.
Farrokh S, Roels C, Owusu KA, Nelson SE, Cook AM
Neurocrit Care 2021 Apr;34(2):593-607. Epub 2020 Aug 13 doi: 10.1007/s12028-020-01061-8. PMID: 32794143
Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications.
Cosci F, Chouinard G
Psychother Psychosom 2020;89(5):283-306. Epub 2020 Apr 7 doi: 10.1159/000506868. PMID: 32259826
Alcohol withdrawal syndrome management: Is there anything new?
Airagnes G, Ducoutumany G, Laffy-Beaufils B, Le Faou AL, Limosin F
Rev Med Interne 2019 Jun;40(6):373-379. Epub 2019 Mar 7 doi: 10.1016/j.revmed.2019.02.001. PMID: 30853380

Diagnosis

Clinical Management of Opioid Withdrawal.
Torres-Lockhart KE, Lu TY, Weimer MB, Stein MR, Cunningham CO
Addiction 2022 Sep;117(9):2540-2550. Epub 2022 Feb 22 doi: 10.1111/add.15818. PMID: 35112746
Clinical management of cannabis withdrawal.
Connor JP, Stjepanović D, Budney AJ, Le Foll B, Hall WD
Addiction 2022 Jul;117(7):2075-2095. Epub 2022 Jan 10 doi: 10.1111/add.15743. PMID: 34791767Free PMC Article
Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications.
Cosci F, Chouinard G
Psychother Psychosom 2020;89(5):283-306. Epub 2020 Apr 7 doi: 10.1159/000506868. PMID: 32259826
Alcohol withdrawal syndrome: mechanisms, manifestations, and management.
Jesse S, Bråthen G, Ferrara M, Keindl M, Ben-Menachem E, Tanasescu R, Brodtkorb E, Hillbom M, Leone MA, Ludolph AC
Acta Neurol Scand 2017 Jan;135(1):4-16. Epub 2016 Sep 1 doi: 10.1111/ane.12671. PMID: 27586815Free PMC Article
Recognition and management of withdrawal delirium (delirium tremens).
Schuckit MA
N Engl J Med 2014 Nov 27;371(22):2109-13. doi: 10.1056/NEJMra1407298. PMID: 25427113

Therapy

Beyond benzodiazepines: a meta-analysis and narrative synthesis of the efficacy and safety of alternative options for alcohol withdrawal syndrome management.
Fluyau D, Kailasam VK, Pierre CG
Eur J Clin Pharmacol 2023 Sep;79(9):1147-1157. Epub 2023 Jun 28 doi: 10.1007/s00228-023-03523-2. PMID: 37380897
Enteral nutritional therapy for induction of remission in Crohn's disease.
Narula N, Dhillon A, Zhang D, Sherlock ME, Tondeur M, Zachos M
Cochrane Database Syst Rev 2018 Apr 1;4(4):CD000542. doi: 10.1002/14651858.CD000542.pub3. PMID: 29607496Free PMC Article
Peripheral edema associated with calcium channel blockers: incidence and withdrawal rate--a meta-analysis of randomized trials.
Makani H, Bangalore S, Romero J, Htyte N, Berrios RS, Makwana H, Messerli FH
J Hypertens 2011 Jul;29(7):1270-80. doi: 10.1097/HJH.0b013e3283472643. PMID: 21558959
Adverse effects.
Rossini PM
Clin Ter 2010;161(1):89-90. PMID: 20393687
Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS).
CONSENSUS Trial Study Group
N Engl J Med 1987 Jun 4;316(23):1429-35. doi: 10.1056/NEJM198706043162301. PMID: 2883575

Prognosis

Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine through 6 Months.
Thomas SJ, Moreira ED Jr, Kitchin N, Absalon J, Gurtman A, Lockhart S, Perez JL, Pérez Marc G, Polack FP, Zerbini C, Bailey R, Swanson KA, Xu X, Roychoudhury S, Koury K, Bouguermouh S, Kalina WV, Cooper D, Frenck RW Jr, Hammitt LL, Türeci Ö, Nell H, Schaefer A, Ünal S, Yang Q, Liberator P, Tresnan DB, Mather S, Dormitzer PR, Şahin U, Gruber WC, Jansen KU; C4591001 Clinical Trial Group
N Engl J Med 2021 Nov 4;385(19):1761-1773. Epub 2021 Sep 15 doi: 10.1056/NEJMoa2110345. PMID: 34525277Free PMC Article
Cabozantinib in patients with advanced Ewing sarcoma or osteosarcoma (CABONE): a multicentre, single-arm, phase 2 trial.
Italiano A, Mir O, Mathoulin-Pelissier S, Penel N, Piperno-Neumann S, Bompas E, Chevreau C, Duffaud F, Entz-Werlé N, Saada E, Ray-Coquard I, Lervat C, Gaspar N, Marec-Berard P, Pacquement H, Wright J, Toulmonde M, Bessede A, Crombe A, Kind M, Bellera C, Blay JY
Lancet Oncol 2020 Mar;21(3):446-455. Epub 2020 Feb 17 doi: 10.1016/S1470-2045(19)30825-3. PMID: 32078813Free PMC Article
A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based?
Davies J, Read J
Addict Behav 2019 Oct;97:111-121. Epub 2018 Sep 4 doi: 10.1016/j.addbeh.2018.08.027. PMID: 30292574
Will This Hospitalized Patient Develop Severe Alcohol Withdrawal Syndrome?: The Rational Clinical Examination Systematic Review.
Wood E, Albarqouni L, Tkachuk S, Green CJ, Ahamad K, Nolan S, McLean M, Klimas J
JAMA 2018 Aug 28;320(8):825-833. doi: 10.1001/jama.2018.10574. PMID: 30167704Free PMC Article
Nivolumab plus ipilimumab as first-line treatment for advanced non-small-cell lung cancer (CheckMate 012): results of an open-label, phase 1, multicohort study.
Hellmann MD, Rizvi NA, Goldman JW, Gettinger SN, Borghaei H, Brahmer JR, Ready NE, Gerber DE, Chow LQ, Juergens RA, Shepherd FA, Laurie SA, Geese WJ, Agrawal S, Young TC, Li X, Antonia SJ
Lancet Oncol 2017 Jan;18(1):31-41. Epub 2016 Dec 5 doi: 10.1016/S1470-2045(16)30624-6. PMID: 27932067Free PMC Article

Clinical prediction guides

Predictive factors of weaning from mechanical ventilation and extubation outcome: A systematic review.
Baptistella AR, Sarmento FJ, da Silva KR, Baptistella SF, Taglietti M, Zuquello RÁ, Nunes Filho JR
J Crit Care 2018 Dec;48:56-62. Epub 2018 Aug 20 doi: 10.1016/j.jcrc.2018.08.023. PMID: 30172034
Similarities and Differences in Diagnostic Scales.
Xuan B, Li P, Yang L, Li M, Zhou J
Adv Exp Med Biol 2017;1010:133-168. doi: 10.1007/978-981-10-5562-1_8. PMID: 29098672
Utility of spherical human liver microtissues for prediction of clinical drug-induced liver injury.
Proctor WR, Foster AJ, Vogt J, Summers C, Middleton B, Pilling MA, Shienson D, Kijanska M, Ströbel S, Kelm JM, Morgan P, Messner S, Williams D
Arch Toxicol 2017 Aug;91(8):2849-2863. Epub 2017 Jun 13 doi: 10.1007/s00204-017-2002-1. PMID: 28612260Free PMC Article
Post-resuscitation care following out-of-hospital and in-hospital cardiac arrest.
Girotra S, Chan PS, Bradley SM
Heart 2015 Dec;101(24):1943-9. Epub 2015 Sep 18 doi: 10.1136/heartjnl-2015-307450. PMID: 26385451Free PMC Article
The Boston bowel preparation scale: a valid and reliable instrument for colonoscopy-oriented research.
Lai EJ, Calderwood AH, Doros G, Fix OK, Jacobson BC
Gastrointest Endosc 2009 Mar;69(3 Pt 2):620-5. Epub 2009 Jan 10 doi: 10.1016/j.gie.2008.05.057. PMID: 19136102Free PMC Article

Recent systematic reviews

Comparative efficacy and safety of pharmacotherapies for alcohol withdrawal: a systematic review and network meta-analysis.
Bahji A, Bach P, Danilewitz M, Crockford D, El-Guebaly N, Devoe DJ, Saitz R
Addiction 2022 Oct;117(10):2591-2601. Epub 2022 Mar 15 doi: 10.1111/add.15853. PMID: 35194860Free PMC Article
Topical corticosteroid withdrawal ('steroid addiction'): an update of a systematic review.
Hwang J, Lio PA
J Dermatolog Treat 2022 May;33(3):1293-1298. Epub 2021 Feb 4 doi: 10.1080/09546634.2021.1882659. PMID: 33499686
Quetiapine withdrawal: A systematic review.
Monahan K, Cuzens-Sutton J, Siskind D, Kisely S
Aust N Z J Psychiatry 2021 Aug;55(8):772-783. Epub 2020 Oct 16 doi: 10.1177/0004867420965693. PMID: 33059460
Assessment and treatment of the withdrawal syndrome in paediatric intensive care units: Systematic review.
Ávila-Alzate JA, Gómez-Salgado J, Romero-Martín M, Martínez-Isasi S, Navarro-Abal Y, Fernández-García D
Medicine (Baltimore) 2020 Jan;99(5):e18502. doi: 10.1097/MD.0000000000018502. PMID: 32000360Free PMC Article
Withdrawal Symptoms after Serotonin-Noradrenaline Reuptake Inhibitor Discontinuation: Systematic Review.
Fava GA, Benasi G, Lucente M, Offidani E, Cosci F, Guidi J
Psychother Psychosom 2018;87(4):195-203. Epub 2018 Jul 17 doi: 10.1159/000491524. PMID: 30016772

Supplemental Content

Table of contents

    Clinical resources

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