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Case Reports in Psychiatry
Volume 2013, Article ID 367594, 4 pages
http://dx.doi.org/10.1155/2013/367594
Case Report

Clonazepam as Agonist Substitution Treatment for Benzodiazepine Dependence: A Case Report

1Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Via Roma, 67, 56100 Pisa, Italy
2Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Lucca, 55045 Pietrasanta, Italy
3G. De Lisio Institute of Behavioural Sciences, 56100 Pisa, Italy

Received 17 December 2012; Accepted 14 January 2013

Academic Editors: D. De Leo and M. Kluge

Copyright © 2013 Angelo Giovanni Icro Maremmani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Nowadays, the misuse of benzodiazepines (BZDs) is a cause for a serious concern among pharmacologically inexperienced patients, whether treated or untreated, that could lead to significant complications, including tolerance, dependence, and addiction. We present a case report in which an Italian patient affected by anxiety disorder and treated with BZDs presented a severe case of dependence on BZDs. We treated him according to an agonist substitution approach, switching from the abused BZD to a slow-onset, long-acting, high potency agonist (clonazepam), and looking at the methadone treatment model as paradigm. We decided to use clonazepam for its pharmacokinetic properties. The advantage of choosing a slow-onset, long-lasting BZD for the treatment of our patient was that it led us to a remarkable improvement in the clinical situation, including the cessation of craving, absence of withdrawal symptoms, reduced anxiety, improvements in social functioning, and a better cognition level.