Piracetam and Ginkgo biloba in the treatment of residual cognitive symptoms after the discontinuation of benzodiazepines in long-term users; case series and review of the literature

Introduction Long-term benzodiazepine use is common although not routinely recommended. While their dependence potential notorious, cognitive problems due to chronic have only recently been intensively studied. Residual symptoms may linger months after successful discontinuation and significantly limit optimal functional outcome in abstinent individuals. Objectives We present a series of cases, 41-year-old man 33-year-old woman who successfully completed ten-week benzodiazepine-dependence rehabilitation program at our hospital, including tapering post-withdrawal integrative therapy. At subsequent monthly outpatient check-ups, abstinence was confirmed (including toxicology testing) there no residual anxiety or mood symptomatology. Still, patients complained suboptimal functioning problems, especially trouble concentrating short-memory deficits, which were objectively via psychometric tests. Methods During continuous treatment (monthly controls), clinically neurocognitively evaluated. They reluctant try conventional psychopharmacology agents but open supplement After thorough literature review, trial piracetam Ginko biloba extract suggested. Piracetam, positive allosteric modulator AMPA-receptors, has used the vascular neurocognitive changes elderly. Bilobalides from G. , act as atypical antagonists GABA-A receptors found exert neuroprotective effects animal models, without epileptogenic anxiogenic risks. Results Patients recommended (2.4 g day) divided doses once-daily dose (240 mg day), standardized form containing 3.2% bilobalides. No side noticed. checkups, reported fewer better everyday functioning. Neurocognitive testing subjective findings, with all areas, so verbal memory, be this specific pharmacological combination. end observation period sixth months, gradually discontinued while given free choice whether continue supplementation. Conclusions According prove beneficial discontinuation, long-term users. Other treatments, focusing on modulation glutamate GABA, also other pathways should Further clinical studies are warranted. Disclosure Interest None Declared