Xavier Laqueille

Centre Hospitalier Sainte Anne, Lutetia Parisorum, Île-de-France, France

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Publications (70)240.88 Total impact

  • Johan Cohen, Alain Dervaux, Xavier Laqueille
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    ABSTRACT: Drug treatments used in substance use disorders are not effective in all patients.
    Presse medicale (Paris, France : 1983). 07/2014;
  • Bulletin de l'Académie nationale de médecine 02/2014; 197(2):503-5. · 0.16 Impact Factor
  • La Presse Médicale 01/2014; · 0.87 Impact Factor
  • La Presse Médicale. 01/2014;
  • Johan Cohen, Alain Dervaux, Xavier Laqueille
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    ABSTRACT: Background Drug treatments used in substance use disorders are not effective in all patients. Objective To assess the effectiveness of topiramate use in the treatment of substance use disorders. Information sources Medline database from January 1966 to December 2013, Cochrane database and clinicaltrials.gov. Selection of studies We used keywords topiramate, addiction, substance abuse, alcohol, tobacco, nicotine, cocaine, methamphetamine, opiate, heroin, benzodiazepine, cannabis, bulimia nervosa, binge eating disorder, gambling. All clinical trials were included. Animal trials, laboratory tests, reviews, answers to writers, case-reports, case series and publications unrelated to the topic were excluded. Twenty-eight articles investigating the efficacy of topiramate in substance use were included. Results In alcohol-related disorder, several trials and a meta-analysis showed a reduction of days of consumption. In a single-center trial on tobacco-related disorder, topiramate was not found effective in reducing the carbon monoxide expired. In cocaine-related disorder, one single-center trial showed a reduction of days of consumption and two single-center trials have found a trend in favour of topiramate. In alcohol and cocaine co-dependency, a single-center trial found a trend in favour of topiramate. In methamphetamine-related disorder, a multicenter trial found a trend in favour of topiramate. In bulimia nervosa, two single-center trials showed a reduction in binge eating and compensatory behaviours. In binge eating disorder, several trials showed a reduction of binge eating and weight. In gambling, one single-center trial did not show any significant results. There were no randomized controlled trials found in opioid-related disorder, benzodiazepines-related disorder, and cannabis-related disorder. Limitations Definition of abstinence and methods to assess the efficacy of topiramate differed between trials. The methodological quality of included trials was variable, especially with no double-blind procedure in eight trials. Conclusion Topiramate showed interest mainly in alcoholism, binge eating disorder and bulimia nervosa. No definitive conclusions can be reached for other substance use disorders such as nicotine dependence, cocaine dependence, amphetamine dependence or cannabis dependence and for gambling.
    La Presse Médicale. 01/2014;
  • Xavier Laqueille, Alain Dervaux
    La Revue du praticien 12/2013; 63(10):1438-40.
  • European Psychiatry 11/2013; 28(8):10. · 3.29 Impact Factor
  • The Journal of neuropsychiatry and clinical neurosciences 10/2013; 25(4):E24. · 2.34 Impact Factor
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    ABSTRACT: Contexte La méthadone est utilisée en France dans l’indication de traitement de substitution de la dépendance aux opiacés depuis 1969. Néanmoins, la durée pendant laquelle ce traitement doit être maintenu et ses modalités d’arrêt sont imprécises. Objectif Conduire une revue de la littérature sur le moment et les stratégies d’arrêt du traitement de substitution par méthadone et recueillir des opinions d’expert. Sources documentaires Nous avons conduit une recherche PubMed, Embase, Cochrane Library et PsycINFO sur la période 1966–2011 en utilisant les mots clés methadone, maintenance, detoxification, tapering, cessation, withdrawal et dans des revues d’addictologie françaises non indexées. Nous avons également recueilli l’opinion du médecin responsable du centre de soins ayant la plus longue expérience de prescription de méthadone en France (depuis 1969). Sélection des études Nous avons exclu les études qui envisageaient la méthadone comme traitement bref du sevrage en opiacés et retenu 23 articles. Résultats Il existe un consensus sur le moment où l’on peut arrêter le traitement par méthadone, déterminé par le volontariat du patient, l’appréciation par le clinicien que le patient est stable depuis une durée suffisante mais aussi la motivation du patient et sa capacité à concevoir sa vie future sans substitution. De même, il existe une majorité d’articles prônant des modalités d’arrêt fondées sur des approches pragmatiques, utilisant des décroissances progressives, en ambulatoire, avec possibilité de retour en arrière en cas d’apparition de consommations d’héroïne, de symptômes de sevrage, ou de symptômes psychiatriques. Limites du travail Le nombre d’article est limité et nous avons trouvé peu d’études prospectives comparant différentes stratégies d’arrêt. Conclusion La substitution n’est pas forcément un traitement à vie pour tous les patients et son arrêt peut être envisagé au sein du cadre de prescription c’est-à-dire accompagné d’un suivi médical, psychologique et social.
    La Presse Médicale. 01/2013; 42(1):e28–e36.
  • Alain Dervaux, Xavier Laqueille
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    ABSTRACT: The main characteristics of cannabis dependence are craving, persistent desire or unsuccessful efforts to cut down or control cannabis use and important social, occupational, or recreational activities given up or reduced because of cannabis use. Withdrawal symptoms include insomnia, irritability, anger, restlessness, depression, mood swings and cravings. Regular cannabis use induces cognitive impairment, especially of attention, episodic memory and working memory. Alcohol and other substances abuse or dependence are frequently found in patients with cannabis dependence. Psychiatric comorbidities are frequent in patients with cannabis dependence, in particular anxiety disorders, mood disorders, and personality disorders. The treatment of cannabis dependence includes behavioral psychotherapy, especially motivational interviewing and cognitive-behavioral therapy, alongside treatment of co-occurring mental health and substance use conditions. There are currently no available pharmacological treatment interventions for cannabis dependence. The treatment of cannabis dependence and withdrawal remains nonspecific.
    La Presse Médicale 10/2012; · 0.87 Impact Factor
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    ABSTRACT: BACKGROUND: Methadone is prescribed in France as a maintenance treatment for heroin dependence since 1969. Nevertheless, the optimal duration of methadone maintenance treatment and how detoxification from methadone at the end of the treatment should be performed is still discussed. OBJECTIVE: To conduct a literature review on when and how detoxify clients from methadone maintenance treatment and to collect the opinion of experts in the field. DOCUMENTARY SOURCES: We searched the PubMed, Embase, Cochrane Library and PsycINFO databases on the 1966-2011 period using the keywords "methadone", "maintenance", "detoxification", "tapering", "cessation", "withdrawal". We also searched data in other addictive journals in French that are not available in those databases. We also collected the opinion of the physician in charge of the oldest methadone program in France (1969). STUDIES SELECTION: We excluded studies that used methadone as short time treatment of heroin withdrawal and thus selected 23 articles. RESULTS: There is a consensus on when methadone maintenance treatment should be stopped, defined by the client's will to stop, the judgement from the physician that the client has been stable for a period of time that is long enough, but also the client's motivation to live his life without maintenance treatment. There is also a majority, among articles on how methadone treatment should be stopped, recommending ambulatory, practical approaches using slow tapering of the dose, with the ability to go back to the previous dose if needed, namely in case of relapse to heroin use, heavy withdrawal or psychiatric symptoms. LIMITS: There are few articles addressing the subject, especially comparing prospectively different cessation strategies. CONCLUSION: Methadone maintenance treatment should not necessarily be maintained all life long and can be stopped within its prescription setting, including medical, psychological and social evaluation.
    La Presse Médicale 05/2012; · 0.87 Impact Factor
  • Alain Dervaux, Xavier Laqueille
    The Lancet 03/2012; 379(9819):892-3; author reply 894. · 39.21 Impact Factor
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    ABSTRACT: Introduction For the past 40 years, methadone has been known to be an efficient treatment of substitution. Its use allowed a significant reduction in the mortality related to opioid addiction. Since 2001, many articles have reported some cases of syncope, wave burst arrhythmia, ventricular tachycardia due to prolonged QT interval and sudden death secondary to cardiac arrest, with a risk of prolongation of the QT interval above 440 ms (men) and 460 ms (women). Many explorations have helped in understanding the physiopathology by showing that opioids, including methadone, cause a blockage of the potassium channels of the gene HERG K+P. This event could slow the repolarisation and the atrioventricular cardiac synchronization and could induce ventricular arrhythmia. Literature findings Nearly 20 studies showed a prolonged QT interval secondary to methadone in patients exhibiting the following features: (1) patients with cardiac pathologies, notably bradycardia, congenital long QT interval, myocardial pathologies related to AIDS and electrolyte disturbances; (2) patients receiving concomitant treatment with substances known to prolong QT interval, such as psychoactive stimulants, narcoleptics, tricyclic antidepressants, antiarrhythmic agents, macrolids, quinolones, non diuretic hypokalemiants and certain corticoids; (3) patients receiving treatments that inhibit methadone's metabolism, particularly those that act on the cytochrome P450 3A4 such as SSRI, antifungal agents, some macrolids and some retroviral agents. Many recent studies, while evaluating the dose-dependent effect of methadone on the QT prolongation, showed a tendency to a prolonged QT when using higher doses of methadone. Conclusion Screening for these risk factors should be carried out before prescribing methadone. EKG should not be systematically performed unless the conditions described above are present or if a higher dose of methadone is needed.
    Encephale-revue De Psychiatrie Clinique Biologique Et Therapeutique - ENCEPHALE. 02/2012;
  • [Show abstract] [Hide abstract]
    ABSTRACT: For the past 40 years, methadone has been known to be an efficient treatment of substitution. Its use allowed a significant reduction in the mortality related to opioid addiction. Since 2001, many articles have reported some cases of syncope, wave burst arrhythmia, ventricular tachycardia due to prolonged QT interval and sudden death secondary to cardiac arrest, with a risk of prolongation of the QT interval above 440 ms (men) and 460 ms (women). Many explorations have helped in understanding the physiopathology by showing that opioids, including methadone, cause a blockage of the potassium channels of the gene HERG K+P. This event could slow the repolarisation and the atrioventricular cardiac synchronization and could induce ventricular arrhythmia. Nearly 20 studies showed a prolonged QT interval secondary to methadone in patients exhibiting the following features: (1) patients with cardiac pathologies, notably bradycardia, congenital long QT interval, myocardial pathologies related to AIDS and electrolyte disturbances; (2) patients receiving concomitant treatment with substances known to prolong QT interval, such as psychoactive stimulants, narcoleptics, tricyclic antidepressants, antiarrhythmic agents, macrolids, quinolones, non diuretic hypokalemiants and certain corticoids; (3) patients receiving treatments that inhibit methadone's metabolism, particularly those that act on the cytochrome P450 3A4 such as SSRI, antifungal agents, some macrolids and some retroviral agents. Many recent studies, while evaluating the dose-dependent effect of methadone on the QT prolongation, showed a tendency to a prolonged QT when using higher doses of methadone. Screening for these risk factors should be carried out before prescribing methadone. EKG should not be systematically performed unless the conditions described above are present or if a higher dose of methadone is needed.
    L Encéphale 02/2012; 38(1):58-63. · 0.49 Impact Factor
  • Source
    S Skanavi, X Laqueille, H-J Aubin
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    ABSTRACT: In substance use disorders, the lack of empirically supported treatments and the minimal utilization of available programs indicate that innovative approaches are needed. Mindfulness based therapies have been used in addictive disorders for the last 10years. Mindfulness can be defined as the ability to focus open, non-judgmental attention to the full experience of internal and external phenomena, moment by moment. Several therapies based on mindfulness have been developed. The aim of this study is to review the existing data on the use of these programs in addictive disorders. We have reviewed the literature published from January 1980 to January 2009, using the following keywords: mindfulness, mindfulness based stress reduction program, dialectical behavior therapy, acceptance and commitment therapy, mindfulness based cognitive therapy, addiction, substance use, alcohol and smoking. Results of six clinical trials evaluating four different programs were found. Five studies were controlled and four were randomized. Drop-out rates were relatively high (from 28 to 55%). In five cases out of six, the program significantly reduced substance use. In four comparative trials out of five, interventions based on mindfulness proved more effective than control conditions. The effectiveness of interventions based on mindfulness and the differential improvement across conditions became greater and was maintained during follow-up when it was long enough. Participants in mindfulness programs were less likely to endorse the importance of reducing emotions associated with smoking and reported significant decreases in avoidance of thoughts which partially mediated alcohol use reduction. Psychiatric symptoms and the level of perceived stress were also significantly reduced. Mindfulness may help substance abusers to accept unusual physical sensations that might be confused with withdrawal symptoms, decentre from a strong urge and not act impulsively. It may reduce an individual's susceptibility to act in response to a drug cue. Practice of mindfulness may develop the ability to maintain perspective in response to strong emotional states and mood fluctuations and increase the saliency of natural reinforcers. Mindfulness based programs require an intensive participation, and should therefore be proposed to highly motivated patients. In smoking cessation, they should be used in patients who were unable to quit with less intensive interventions. Some programs are specifically designed for patients with co-occurring psychiatric disorders. The first clinical studies testing mindfulness based interventions in substance use disorders have shown promising results. They must be confirmed by larger controlled randomized clinical trials. By developing a better acceptance of unusual physical sensations, thoughts about drugs and distressing emotions, mindfulness may help in reducing the risk of relapse.
    L Encéphale 10/2011; 37(5):379-87. · 0.49 Impact Factor
  • Source
    Alain Dervaux, Marie-Odile Krebs, Xavier Laqueille
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    ABSTRACT: Several prospective studies in the general population [1–5] and meta-analyses [6–7] have consistently found that cannabis use is associated with an increased risk of psychotic disorders, in particular schizo-phrenia. Continued cannabis use over time increases the risk of psychosis in a dose–response fashion [3–5]. A higher risk of schizophrenia is predicted by an earlier age of cannabis use [1,6–7]. Several hypotheses have been suggested to explain the association between canna-bis use and schizophrenia, including the following [6,8]: ƒ Cannabis use is a causal factor for schizophrenia; ƒ Cannabis use precipitates psychosis in vulnerable people; ƒ Cannabis use exacerbates symptoms of schizophrenia; ƒ Patients with schizophrenia are more liable to become regular cannabis users, including during the prodromal phase. Ferdinand et al. investigated the role of pre-existing self-reported psychotic symp-toms and found a bidirectional association between cannabis and psychotic symptoms in a 14-year follow-up study in the general population [9]. They showed that cannabis use in individuals who did not have psy-chotic symptoms before they began using cannabis predicted later psychotic symp-toms and that the reverse was also true, in that psychotic symptoms in those who had never used cannabis before the onset of psychotic symptoms also predicted future cannabis use. However, in a recent 10-year follow-up study, Kuepper et al. clarified the tempo-ral association between cannabis use and psychotic experiences by systematically For reprint orders, please contact: reprints@futuremedicine.com
    Neuropsychiatry 06/2011; 1(3):203-207.
  • B. Martin, X. Laqueille
    L'Encéphale. 06/2011; 37(3):245.
  • Source
    S. Skanavi, X. Laqueille, H.-J. Aubin
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction In substance use disorders, the lack of empirically supported treatments and the minimal utilization of available programs indicate that innovative approaches are needed. Mindfulness based therapies have been used in addictive disorders for the last 10 years. Mindfulness can be defined as the ability to focus open, non-judgmental attention to the full experience of internal and external phenomena, moment by moment. Several therapies based on mindfulness have been developed. The aim of this study is to review the existing data on the use of these programs in addictive disorders. Methods We have reviewed the literature published from January 1980 to January 2009, using the following keywords: mindfulness, mindfulness based stress reduction program, dialectical behavior therapy, acceptance and commitment therapy, mindfulness based cognitive therapy, addiction, substance use, alcohol and smoking. Results Results of six clinical trials evaluating four different programs were found. Five studies were controlled and four were randomized. Drop-out rates were relatively high (from 28 to 55%). In five cases out of six, the program significantly reduced substance use. In four comparative trials out of five, interventions based on mindfulness proved more effective than control conditions. The effectiveness of interventions based on mindfulness and the differential improvement across conditions became greater and was maintained during follow-up when it was long enough. Participants in mindfulness programs were less likely to endorse the importance of reducing emotions associated with smoking and reported significant decreases in avoidance of thoughts which partially mediated alcohol use reduction. Psychiatric symptoms and the level of perceived stress were also significantly reduced. Discussion Mindfulness may help substance abusers to accept unusual physical sensations that might be confused with withdrawal symptoms, decentre from a strong urge and not act impulsively. It may reduce an individual's susceptibility to act in response to a drug cue. Practice of mindfulness may develop the ability to maintain perspective in response to strong emotional states and mood fluctuations and increase the saliency of natural reinforcers. Mindfulness based programs require an intensive participation, and should therefore be proposed to highly motivated patients. In smoking cessation, they should be used in patients who were unable to quit with less intensive interventions. Some programs are specifically designed for patients with co-occurring psychiatric disorders. Conclusion The first clinical studies testing mindfulness based interventions in substance use disorders have shown promising results. They must be confirmed by larger controlled randomized clinical trials. By developing a better acceptance of unusual physical sensations, thoughts about drugs and distressing emotions, mindfulness may help in reducing the risk of relapse.
    Encephale-revue De Psychiatrie Clinique Biologique Et Therapeutique - ENCEPHALE. 01/2011; 37(5):379-387.
  • European Neuropsychopharmacology - EUR NEUROPSYCHOPHARMACOL. 01/2011; 21.
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    ABSTRACT: IntroductionIt has been established that cannabis use is involved in the emergence and evolution of psychotic disorders. Although cannabis use is very frequent in mood disorders, there has been a considerable debate about the association observed between these two disorders. This review aims to clarify the relation between cannabis use and bipolar disorder, in order to unveil a possible causality and find the effect of cannabis on the prognosis and expression of bipolarity.
    Annales Medico-psychologiques - ANN MEDICO-PSYCHOL. 01/2011; 169(5):277-281.

Publication Stats

225 Citations
240.88 Total Impact Points

Institutions

  • 1995–2014
    • Centre Hospitalier Sainte Anne
      Lutetia Parisorum, Île-de-France, France
  • 2010–2012
    • Université Paris Descartes
      • UMR S 894 Centre de Psychiatrie et Neurosciences
      Lutetia Parisorum, Île-de-France, France
  • 2001–2012
    • Université René Descartes - Paris 5
      • • Centre de Psychiatrie et Neurosciences (UMR_S 894)
      • • UMR S 894 Centre de Psychiatrie et Neurosciences
      Lutetia Parisorum, Île-de-France, France