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TREATMENT OF SYMPTOMS

  • Nov 30, 2020
  • 2 min read

A normal and predictable neurophysiological response is always expected when treating with opioids and this response is called physical dependence. If not treated properly will result in withdrawal symptoms. If symptoms appear then following the protocol, symptomatic treatment starts which includes several drugs for symptomatic relief.


MOST COMMON SYMPTOMS:


· Yawning

· Sweating

· Lacrimation

· Rhinorrhea

· Anxiety

· Restlessness

· Insomnia

· Dilated pupil

· piloerection

· Chills

· Tachycardia

· Hypertension

· nausea and vomiting

· cramping abdominal pains

· diarrhea

· muscle aches

MOST COMMONLY USED DRUGS:


CLONIDINE:


Clonidine is an alpha-adrenergic agonist that excites the pathway that inhibits the excitation of cardiovascular neurons. This drug is used to treat autonomic hyperactivity symptoms. The only drawback of this drug is that it causes hypotension. Compared to methadone, it has more side effects. (Jasinski et al., 1985)


Dose:


0.1-0.2 mg PO Q 4-6 hours PRN

Or by transdermal patches which provide 0.1 mg per day for 7 days.


DICYCLOMINE:


This is a carboxylic acid derivative and a selective anticholinergic and anti-spasmodic drug. It relieves the patient with muscle spasm by blocking the binding of acetylcholine with muscarinic receptors on smooth muscle thus relieves from abdominal pains. (Page & Dirnberger, 1981) Other drugs used for the same relive are:

Lomotil and Bentyl.


HYDROXYZONE:


Hydroxyzine is an antihistamine drug used to relieve the watery eyes, itchy, runny nose, and other allergic symptoms seen with the withdrawal of opioids.

TRAZODONE:


This is an antidepressant drug that acts both by serotonin transporter inhibition and the receptors. It has a major role in reliving the psychiatric effects of withdrawal for example depression, anxiety, restlessness, insomnia, etc.


NSAIDs:


Non-steroidal anti-inflammatory drugs have a major role in controlling the pain related to the withdrawal of opioids like abdominal pain and body aches. This group includes ibuprofen, acetaminophen, naproxen, diclofenac sodium, and aspirin.



ONDANSETRON:


Opioid withdrawal becomes difficult to treat. There are studies to show the use of ondansetron for its symptoms for example GIT side effects. Ondansetron, commonly known as Zofran, widely used to prevent nausea and vomiting. It is a serotonin 5-HT3 receptor antagonist thus blocks the serotonin with is a chemical responsible for nausea and vomiting. (Chu et al., 2017)


BENZODIAZEPINES:


Alprazolam, diazepam, midazolam, lorazepam these drugs are commonly known as tranquilizers are widely used when patients with withdrawal symptoms are having anxiety issues. It works by calming the patient and induce a sedative effect by increasing the number of inhibitory neurotransmitters in the brain called GABA. (Rockville (MD), 2006)


LOPRAMIDE:


Symptoms like diarrhea can be treated by giving loperamide. It acts by slowing down the intestinal motility and balance the water and electrolyte concentration by moving them through the bowel.


All these drugs and many more are used to treat the symptoms of withdrawal although, this is not the goal of therapy. This is just a part of the process. The main aim is to make a patient free from the adverse effects of opioids and its dependence.




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About Dr. Viveck Baluja and KneeTie Vascular Neurology

Dr. Viveck Baluja, MD, is a board-certified vascular neurologist (American Board of Psychiatry and Neurology — Vascular Neurology) practicing telemedicine across California, Michigan, and Colorado, with additional consultation services available to international families, particularly in India.

KneeTie offers three focused services: emergency stroke second opinions delivered within 24 hours, traumatic brain injury (TBI) consultations for survivors and caregivers, and same-day adult ADHD evaluations for residents of CA, MI, and CO.

Stroke Second Opinion

After a stroke, families often have minutes to make decisions. Dr. Baluja provides a second set of expert eyes from a board-certified vascular neurologist — reviewing imaging, hospital records, and current treatment — typically within 24 hours of request. Common questions include: Was tPA appropriate? Should we pursue thrombectomy? What is the recovery outlook? What rehabilitation makes sense?

TBI Consultation

Traumatic brain injury recovery is rarely linear. Dr. Baluja helps patients and families understand recovery timelines, treatment options, post-concussion syndrome, and red flags that warrant emergency evaluation. Consultations typically last 50 minutes and are scheduled within the same week.

Same-Day Adult ADHD Evaluation

A real evaluation by a board-certified neurologist — not a 7-minute screening. Dr. Baluja's ADHD evaluations include comprehensive history, sleep and lifestyle assessment, and behavioral strategy alongside any medication discussion. Available same-day for residents of California, Michigan, and Colorado.

Why a Vascular Neurologist?

Vascular neurology is a subspecialty focused on stroke, cerebrovascular disease, and brain blood flow — among the rarest neurology subspecialties in the U.S. Most online telehealth services use general practitioners or nurse practitioners. KneeTie is led by a board-certified vascular neurologist with full state licensure and HIPAA-compliant telehealth infrastructure.

Schedule a consultation: Use the booking calendar above to choose a service and reserve a time. For active stroke or post-tPA emergencies, email gorungo@kneetie.com directly with "URGENT" in the subject line.

© 2020 KneeTie, Jagannatha Health LLC 

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