Background: The purpose of this study was to clarify the dynamics of heart rate variability (HRV) in the dynamics of alcohol withdrawal syndrome relief. Methods: We examined 31 patients at an average age of 43. 9 ± 5. 2 years with alcohol withdrawal syndrome (the middle stage, the period of maintenance therapy) and 15 volunteers of comparable age. The control points for assessing HRV were 1 to 2, 3 to 5, 6 to 9, and 10 to 15 days after stopping alcohol consumption. Electrocardiography was performed using the software and hardware complex Polyspectr-12 (Neurosoft, Russia). HRV was evaluated using a set of statistical and spectral analytical methods, including the coefficient of variation (%), and spectral analysis indicators (based on the fast Fourier transform algorithm using all points without smoothing). The geometric analysis of the cycles of nonlinear cardiac rhythm waves was performed using a chaos test via the method of Gavrilushkin (2007). Results: In our patients with alcohol withdrawal syndrome in the rehabilitation period, there was a pronounced instability of the heart rhythm, which was manifested in the increasing role of its intracardiac regulation mechanisms and the stimulating effect of sympathicotonia. The most pronounced shifts in HRV were detected in the period from 3 to 9 days after the cessation of alcohol consumption. Additionally, the risk of arrhythmogenic complications in alcohol withdrawal syndrome was highest from the third to the ninth day of the rehabilitation period. Conclusions: Our patients with alcohol withdrawal syndrome in the rehabilitation period exhibited a pronounced instability in their heart rhythm, manifesting itself in the increasing role of its intracardiac regulation mechanisms and the stimulating effect of sympathicotonia.

Objectives: Several studies indicate that central serotonergic neurons have important role in tolerance and dependency to morphine. The aim of this study was to investigate effect of buspirone (as a partial agonist of 5-HT1A receptors) in severity of morphine withdrawal syndrome in mice. Methods: Study was carried out on Swiss male albino mice weighing 25-30g. In order to induce dependency, we used daily subcutaneous injection of morphine at the schedule of: day 1=5 mg/kg; days 2-3=10 mg/kg; days 4-5=15 mg/kg; days 6-7=20 mg/kg and days 8-9=25mg/kg. Withdrawal syndrome was induced by intraperitoneal (i.p.) injection of naloxone (5 mg/kg) and then straub tail and jumps were recorded during 40 min period as indicators of morphine withdrawal syndrome. In treated groups, buspirone (5, 7.5 and 10 mg/kg, i.p.) was co-injected daily with morphine and severity of naloxone induced withdrawal behaviors were recorded at day 9. Results: Our results showed that naloxone induces sever (P<0.001) withdrawal behaviors (as indicated by straub tail and jumping behaviors) in morphine dependent mice. Daily coinjection of buspirone (5, 7.5 and 10 mg/kg) with morphine caused significant (P<0.001) reduction in straub tail and jumping behaviors. Buspirone (5, 7.5 and 10 mg/kg) did not produced any significant effect on morphine withdrawal syndrome. Conclusion: Results of this study show that buspirone attenuates morphine withdrawal behaviors.

A 2 day old term male newborn infant was admitted in our neonatal intensive care unit with irritability and jittery movements. No remarkable findings were detected on physical examination except irritability, increased tonus, and jitteriness. All of the paraclinical studies were within normal limits. His mother had been on 20 mg fluoxetine throughout her pregnancy for depression. The patient recovered quickly after supportive care, with no possible cause other than his mother’s drug use. The symptoms were interpreted as withdrawal syndrome caused by the mother’s use of fluoxetine during pregnancy. It is recommended that neonates born to mothers who have taken antidepressants up to delivery be observed during the first few postnatal days.

Introduction: This study was conducted to evaluate the efficacy of Amitriptyline treatment in opioid withdrawal syndrome. Materials and Methods: A total of 44 opium dependent patients who met the DSMIV -TR criteria for opioid dependency were randomly assigned to treat with 'Amitriptyline or placebo during a 25-day double blind clinical trial. Opioid misuse was replaced by oral methadone during a 3 days stabilization period. Methadone was reduced to zero from the beginning of the study to 10th day and Amitriptylin or placebo also was administered. Amitriptylin prescribed as 25 mg tablets or placebo tablets that were completely similar to Amitriptylin tablet prescribed too. Amitriptylin group were prescribed 25 mg tablet per day and placebo tablet too. From second week, drug dosages for both groups were doubled. Rapid detoxification was performed by naloxon after 5 days washout period. The severity of opioid withdrawal and pain was measured by sows and MPQ at days 7/15/17 and 25. Results: There 'was significant difference between Amitriptyline and placebo in reduction of opioid - withdrawal pain and mental symptoms. No significant difference was noted between the two groups on physical symptoms of withdrawal syndromes. Conclusion: Amitriptyline can be considered as an adjuvant drug for opioid withdrawal pain Management.