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April 1983, Vol 137, No. 4 >
Article | April 1983

Opiate v CNS Depressant Therapy in Neonatal Drug Abstinence Syndrome FREE

Stephen R. Kandall, MD; Tatiana M. Doberczak, MD; Kenneth R. Mauer; Robert H. Strashun, MD; David C. Korts, PhD
[+] Author Affiliations

Reprint requests to Division of Neonatology, Beth Israel Medical Center, 10 Nathan D. Perlman Pl, New York, NY 10003 (Dr Kandall).


Am J Dis Child. 1983;137(4):378-382. doi:10.1001/archpedi.1983.02140300056015.
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• Paregoric and phenobarbital, administered randomly in 153 passively addicted neonates, initially appeared to control neonatal abstinence signs equally well. However, seven of the 62 phenobarbital treated newborns had abstinence-associated seizures within the first month of life, while none of 49 paregoric-treated neonates had seizures. Forty-two neonates initially requiring no specific pharmacotherapy for abstinence signs were born to mothers taking less methadone hydrochloride just before delivery. Five of those 42 neonates, however, had seizures within the first 14 days of life. Seizure occurrence could not be predicted from analysis of early abstinence patterns. We consider paregoric to be the treatment of choice for the neonatal abstinence syndrome. Phenobarbital use should be monitored with serum drug levels and modification of recommended dosage regimens considered.

(Am J Dis Child 1983;137:378-382)

REFERENCES

1 +
Hill RM, Desmond MM:  Management of the narcotic withdrawal syndrome in the neonate . Pediatr Clin North Am 1963;;10:67-85.
2 +
Reddy AM, Harper RG, Stern G:  Observations on heroin and methadone withdrawal in the newborn . Pediatrics 1971;;48:353-357.
3 +
Zelson C, Rubio E, Wasserman E:  Neonatal narcotic addiction: Ten-year observation . Pediatrics 1971;;48:178-189.
4 +
Ostrea EM Jr, Chavez CJ, Strauss ME:  A study of factors that influence the severity of neonatal narcotic withdrawal . J Pediatr 1976;;88:642-645.
5 +
Kandall SR, Albin S, Gartner LM, et al:  The narcotic-dependent mother: Fetal and neonatal consequences . Early Hum Devel 1977;;1/2:159-169.
6 +
Madden JD, Chappel JN, Zuspan F, et al:  Observation and treatment of neonatal narcotic withdrawal . Am J Obstet Gynecol 1977;;127:199-201.
7 +
Harper RG, Solish G, Feingold E, et al:  Maternal ingested methadone, body fluid methadone, and the neonatal withdrawal syndrome . Am J Obstet Gynecol 1977;;129:417-424.
8 +
Finnegan LP:  Pathophysiological and behavioural effects of the transplacental transfer of narcotic drugs to the foetuses and neonates of narcotic-dependent mothers . Bull Narc 1979;; 31:1-58.
9 +
Kahn EJ, Neumann LL, Polk GA:  The course of the heroin withdrawal syndrome in newborn infants treated with phenobarbital or chlorpromazine . J Pediatr 1969;;75:495-500.
10 +
Rajegowda BK, Glass L, Evans HE, et al:  Methadone withdrawal in newborn infants . J Pediatr 1972;;81:532-534.
11 +
Kron RE, Litt M, Pheonix MD, et al:  Neonatal narcotic abstinence: Effects of pharmacotherapeutic agents and maternal drug usage on nutritive sucking behavior . J Pediatr 1976;;88: 637-641.
12 +
Dole VP, Kim WK, Eglitis I:  Detection of narcotic drugs, tranquilizers, amphetamines, and barbiturates in urine . JAMA 1966;;198:349-352.
13 +
Lipsitz PJ:  A proposed narcotic withdrawal score for use with newborn infants . Clin Pediatr 1975;;14:592-594.
14 +
 Treatment of neonatal withdrawal syndrome . Med Lett Drugs Ther 1973;;15:46-48.
15 +
Rothstein P, Gould JB:  Born with a habit . Pediatr Clin North Am 1974;;21:307-321.
16 +
Ostrea EM Jr, Wooley PV Jr:  Infants of drug addicted mothers , in Gellis SS, Kagan BM (eds): Current Pediatric Therapy , Philadelphia, WB Saunders Co, 1978;, vol 8, pp 780-782.
17 +
Herzlinger RA, Kandall SR, Vaughan HG Jr:  Neonatal seizures associated with narcotic withdrawal . J Pediatr 1977;;91:638-641.
18 +
Dole VP, Kreek MJ:  Methadone plasma level: Sustained by a reservoir of drug in tissue . Proc Natl Acad Sci USA 1973;;70:10.
19 +
Kandall SR, Gartner LM:  Late presentation of drug withdrawal in newborns . Am J Dis Child 1974;;127:58-61.

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References

1 +
Hill RM, Desmond MM:  Management of the narcotic withdrawal syndrome in the neonate . Pediatr Clin North Am 1963;;10:67-85.
2 +
Reddy AM, Harper RG, Stern G:  Observations on heroin and methadone withdrawal in the newborn . Pediatrics 1971;;48:353-357.
3 +
Zelson C, Rubio E, Wasserman E:  Neonatal narcotic addiction: Ten-year observation . Pediatrics 1971;;48:178-189.
4 +
Ostrea EM Jr, Chavez CJ, Strauss ME:  A study of factors that influence the severity of neonatal narcotic withdrawal . J Pediatr 1976;;88:642-645.
5 +
Kandall SR, Albin S, Gartner LM, et al:  The narcotic-dependent mother: Fetal and neonatal consequences . Early Hum Devel 1977;;1/2:159-169.
6 +
Madden JD, Chappel JN, Zuspan F, et al:  Observation and treatment of neonatal narcotic withdrawal . Am J Obstet Gynecol 1977;;127:199-201.
7 +
Harper RG, Solish G, Feingold E, et al:  Maternal ingested methadone, body fluid methadone, and the neonatal withdrawal syndrome . Am J Obstet Gynecol 1977;;129:417-424.
8 +
Finnegan LP:  Pathophysiological and behavioural effects of the transplacental transfer of narcotic drugs to the foetuses and neonates of narcotic-dependent mothers . Bull Narc 1979;; 31:1-58.
9 +
Kahn EJ, Neumann LL, Polk GA:  The course of the heroin withdrawal syndrome in newborn infants treated with phenobarbital or chlorpromazine . J Pediatr 1969;;75:495-500.
10 +
Rajegowda BK, Glass L, Evans HE, et al:  Methadone withdrawal in newborn infants . J Pediatr 1972;;81:532-534.
11 +
Kron RE, Litt M, Pheonix MD, et al:  Neonatal narcotic abstinence: Effects of pharmacotherapeutic agents and maternal drug usage on nutritive sucking behavior . J Pediatr 1976;;88: 637-641.
12 +
Dole VP, Kim WK, Eglitis I:  Detection of narcotic drugs, tranquilizers, amphetamines, and barbiturates in urine . JAMA 1966;;198:349-352.
13 +
Lipsitz PJ:  A proposed narcotic withdrawal score for use with newborn infants . Clin Pediatr 1975;;14:592-594.
14 +
 Treatment of neonatal withdrawal syndrome . Med Lett Drugs Ther 1973;;15:46-48.
15 +
Rothstein P, Gould JB:  Born with a habit . Pediatr Clin North Am 1974;;21:307-321.
16 +
Ostrea EM Jr, Wooley PV Jr:  Infants of drug addicted mothers , in Gellis SS, Kagan BM (eds): Current Pediatric Therapy , Philadelphia, WB Saunders Co, 1978;, vol 8, pp 780-782.
17 +
Herzlinger RA, Kandall SR, Vaughan HG Jr:  Neonatal seizures associated with narcotic withdrawal . J Pediatr 1977;;91:638-641.
18 +
Dole VP, Kreek MJ:  Methadone plasma level: Sustained by a reservoir of drug in tissue . Proc Natl Acad Sci USA 1973;;70:10.
19 +
Kandall SR, Gartner LM:  Late presentation of drug withdrawal in newborns . Am J Dis Child 1974;;127:58-61.

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