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J Clin Psychiatry 2001 Jun;62(6):475-6

Topiramate abuse in a bipolar patient with an eating disorder.

Colom F, Vieta E, Benabarre A, Martinez-Aran A, Reinares M, Corbella B, Gasto C

Publication Types:

PMID: 11465528, UI: 21358055

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J Hepatol 2001 Feb;34(2):346-50

Hepatitis after intravenous buprenorphine misuse in heroin addicts.

Berson A, Gervais A, Cazals D, Boyer N, Durand F, Bernuau J, Marcellin P, Degott C, Valla D, Pessayre D

INSERM U1481 and Service d'Hepatologie, H pital Beaujon, Clichy, France.

BACKGROUND: Sublingual buprenorphine is used as a substitution drug in heroin addicts. Although buprenorphine inhibits mitochondrial function at high concentrations in experimental animals, these effects should not occur after therapeutic sublingual doses, which give very low plasma concentrations. CASE REPORTS: We report four cases of former heroin addicts infected with hepatitis C virus and placed on substitution therapy with buprenorphine. These patients exhibited a marked increase in serum alanine amino transferase (30-, 37-, 13- and 50-times the upper limit of normal, respectively) after injecting buprenorphine intravenously and three of them also became jaundiced. Interruption of buprenorphine injections was associated with prompt recovery, even though two of these patients continued buprenorphine by the sublingual route. A fifth patient carrying the hepatitis C and human immunodeficiency viruses, developed jaundice and asterixis with panlobular liver necrosis and microvesicular steatosis after using sublingual buprenorphine and small doses of paracetamol and aspirin. CONCLUSIONS: Although buprenorphine hepatitis is most uncommon even after intravenous misuse, addicts placed on buprenorphine substitution should be repeatedly warned not to use it intravenously. Higher drug concentrations could trigger hepatitis in a few intravenous users, possibly those whose mitochondrial function is already impaired by viral infections and other factors.

PMID: 11281569, UI: 21177173

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Med J Aust 2001 Jun 4;174(11):607

Strychnine, ammonia and gunpowder for snakebite--the end of an era.

Winkel KD

Department of Pharmacology, University of Melbourne, VIC.

Publication Types:

PMID: 11453337, UI: 21345889

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Med J Aust 2001 Jun 4;174(11):593-4

Neuroleptic malignant syndrome: an underdiagnosed condition.

Harradine PG, Williams SE, Doherty SR

Tamworth Base Hospital, New England Health Service, NSW.

PMID: 11453335, UI: 21345887

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