Best treatment options for reducing withdrawal symptoms and hospital stay in Neonatal Abstinence Syndrome

Abstract

Neonatal Abstinence Syndrome (NAS) is a collection of symptoms a neonate suffers from when there was exposure to illicit or prescription drugs in-utero. Symptoms include diarrhoea, feeding difficulties, weight loss, increased muscle tone and seizures. This study aims to look into the various treatments available, particularly opiates and antiepileptics, with the objective of identifying the one which reduces the withdrawal symptoms most effectively and which results in the shortest hospital stay. A systematic search for evidenced-based studies was carried out with the objective of yielding systematic reviews, randomized controlled trails and review articles. Studies which focused on other forms of therapies apart from pharmacological were excluded from the study. Two systematic reviews, two randomized controlled trials and two review articles were included in this study and were critically appraised via the Critical Appraisal Skills Programme and the Scottish Intercollegiate Guideline Networks. It was established that the best treatment option for NAS depends on the drugs which the neonate was exposed to in-utero. Nonetheless, most neonates are exposed to opiates and thus morphine was found to be the safest and most effective drug when compared to other classes of drugs. The use of phenobarbitone as an adjunct therapy to morphine is also highly encouraged since it reduces the severity of the withdrawal symptoms, resulting in reduced hospitalization duration. Though morphine with phenobarbitone as an adjunct therapy is showing a promising future in treating NAS, further research is needed in the field to compare the various available treatment options and trials are also needed to explore different doses that could be used. Additional research is also needed to explore the long term effects of the treatment given. The local situation should also be looked into and reports of the treatment given should be made available.