Ketamine: A Potential Adjunct for Severe Benzodiazepine Withdrawal.

Following the abrupt cessation of benzodiazepine therapy, patients can present with acute life-threatening withdrawal. Medical management of benzodiazepine withdrawal is typically undertaken with benzodiazepines either through loading dose with gradual taper or symptom triggered treatment, though adjuvant anxiolytics and anticonvulsants are often used. Ketamine, increasingly utilized as an adjunct in the treatment of alcohol withdrawal, may represent an effective medication in the treatment of benzodiazepine withdrawal.

A Case of Thiazide-induced Hypokalemic Paralysis.

We describe the case of a patient presenting with odd neurologic symptoms initially thought to represent somatization who was found to have critical hypokalemia manifesting as hypokalemic non-periodic paralysis. It was determined that the patient had baseline hypokalemia as a function of alcohol abuse, exacerbated by self overmedication with hydrochlorothiazide for elevated blood pressure readings at home. The diagnosis was suspected when an electrocardiogram was obtained demonstrating a pseudo-prolonged QT interval with ST depression, consistent with T-U wave fusion and a QU interval with an absent T wave.