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References 530 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 References National Institute for Health and Care Excellence. Tobacco: preventing uptake, promoting quitting and treating dependence. NICE guideline [NG209]. 2021 (last updated 2023, ...

Stimulant use disorder (SUD)

Overview of treatment 532 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Stimulant use disorder (SUD) Stimulants, as a group, encompass a wide range of synthetics (amfetamine, methamphetamine, methylphenidate, mephedrone) and naturally derived su...

Cocaine

Amfetamines Addictions and substance misuse CHAPTER 4 There is a small developing evidence base for the potential of interventions based on neuromodulation such as transcranial magnetic stimulation (tMS) in SUD. This is an area of research in its early stages,...

Polysubstance abuse

Psychosis associated with stimulant drugs 534 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Detoxification and dependence A withdrawal syndrome is common in those who are dependent. Treatment should focus on symptomatic relief, although many sym...

Stimulant-associated depression

References Addictions and substance misuse CHAPTER 4 ­cannot be co-­administered. Haloperidol should not be used because of the risk of dystonia. Early review regarding continuation is important as for most patients their symptoms resolve within 2 or 3 weeks, ...

GHB and GBL dependence

The withdrawal syndrome1,2

Withdrawal management Addictions and substance misuse CHAPTER 4 GHB and GBL dependence Gamma-­hydroxybutyrate (GHB) and gamma-­butyrolactone (GBL, a pro-­drug of GHB) are colloquially often referred to as ‘G’. They reduce anxiety and produce disinhibition and ...

References Addictions and substance misuse CHAPTER 4 References Kamal RM, et al. Pharmacological treatment in gamma-­hydroxybutyrate (GHB) and gamma-­butyrolactone (GBL) dependence: detoxification and relapse prevention. CNS Drugs 2017; 31:51–64. Bell J, et a...

Benzodiazepine misuse

Withdrawal management 540 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Benzodiazepine misuse Benzodiazepine prescribing reached its peak during the 1960s and 1970s. Prescriptions that were originally started for disorders such as anxiety, depre...

Polysubstance use

Pregnancy and benzodiazepine misuse

Summary Addictions and substance misuse CHAPTER 4 Polysubstance use Illicit benzodiazepines are often used in addition to a primary substance of abuse. People with non-­iatrogenic benzodiazepine dependence often consume doses greater than 100mg diazepam equiva...