Dr. Benhamou received his Bachelor's degree at Duke University and went on to complete medical school at Ben-Gurion University. He completed his residency in Psychiatry at Westchester Medical Center and fellowship in Addiction Medicine at Stanford. He has published works in the areas of suicide, autoimmune encephalitis and addiction. His current interests include substance abuse, the role of transcranial magnetic stimulation on addiction and the intersection of suicide and substance abuse.
Clinical Assistant Professor, Psychiatry and Behavioral Sciences
Clinical Assistant Professor, Psychiatry and Behavioral Sciences
Board Certification: American Board of Preventive Medicine, Addiction Medicine (2021)
Board Certification, American Board of Preventive Medicine, Addiction Medicine (2020)
Fellowship: Stanford University Addiction Medicine Fellowship (2020) CA
Board Certification: American Board of Psychiatry and Neurology, Psychiatry (2019)
Residency: Westchester Medical Center Behavioral Health (2019) NY
Internship: Lenox Hill Hospital Internal Medicine Residency (2014) NY
Medical Education: Ben-Gurion University of the Negev (2012) Israel
Gabapentin dependence and withdrawal requiring an 18-month taper in a patient with alcohol use disorder: a case report.
Journal of addictive diseases
Gabapentin has been widely used to manage post-herpetic neuralgia, peripheral neuropathy, seizure disorders, alcohol use disorder (AUD), alcohol withdrawal, and insomnia. Although usually well tolerated, gabapentin has been reported to cause severe physiologic dependence and withdrawal. Tapering gabapentin in this context poses a significant clinical challenge, with little published information to date on meeting this challenge. This case highlights the need for patient-centered slow tapers in patients with severe gabapentin dependence and withdrawal. We present a 32-year-old female effectively treated for AUD with 1,200mg daily dose of gabapentin, who developed gabapentin dependence and severe withdrawal. Recognizing her intolerance to gabapentin withdrawal after a brief accidental pause of medication, a taper plan was initiated using the framework of the BRAVO Protocol. On average, she reduced daily gabapentin dose by 100mg per month until she reached 300mg. The taper then slowed to 20-30mg dose decrements per month. For the last 100mg, she tapered down at 5mg decrements every one to two weeks to 60mg, at which point she discontinued gabapentin. The entire taper process took eighteen months. The BRAVO protocol outlines a safe and compassionate strategy. Originally developed for opioids and adapted to benzodiazepines, the use of the Bravo Protocol provides a framework for a gabapentin taper. For patients in whom gabapentin treatment leads to severe dependence and withdrawal, the BRAVO Protocol provides a practical, patient-centered framework for tapering.
View details for DOI 10.1080/10550887.2021.1907502
View details for PubMedID 33783336
Case Report: Buprenorphine-A Treatment for Psychological Pain and Suicidal Ideation?
The American journal on addictions
BACKGROUND AND OBJECTIVES: Buprenorphine is commonly used to manage opioid use disorder; however, the literature describes its potential role in treating treatment-resistant depression.METHODS: We present a patient with bipolar disorder and opioid use disorder, who presented status post-suicide attempt.RESULTS: After initiating buprenorphine-naloxone, the patient reported rapid improvement in depressive symptoms, pain, and suicidal ideation.DISCUSSION AND CONCLUSIONS: This case demonstrates buprenorphine's antisuicidal and mood-stabilizing capabilities, potentially via antagonizing kappa-opioid receptors as well as reinstating the balance between reward and antireward circuitry.SCIENTIFIC SIGNIFICANCE: This case highlights buprenorphine-naloxone as a treatment for both treatment-resistant depression and opioid use disorder, as well as buprenorphine's rapid antidepressant, analgesic, and antisuicidal effects. (Am J Addict 2020;00:00-00).
View details for DOI 10.1111/ajad.13063
View details for PubMedID 32662143
171 Buprenorphine - A Treatment for Psychic Pain and Suicidal Ideation?
2020; 25 (2): 309
Buprenorphine (BPN) is an opiate medication that is increasingly used in the management of Opioid Use Disorder and pain disorders. This case report highlights the acute efficacy of using buprenorphine-naloxone (BPN-NAL) to reverse anhedonia and suicidal ideation in an individual with OUD, chronic pain and severe suicide attempts.We present a case of a 39-year-old male with a history of bipolar disorder, several lethal suicide attempts and polysubstance abuse, who presented to the hospital after self-immolation, burning 45% total body surface area. He was admitted to the burn unit for three months, reporting continual anhedonia, suicidal ideation, and flashbacks of seeing and feeling himself on fire. He also endorsed chronic pain and hopelessness.Upon transfer to the behavioral health unit, his symptoms persisted, despite trials of quetiapine, mirtazapine, methadone, oxycodone and prazosin. In consultation with pain management, he was initiated on sublingual BPN-NAL 8mg-2mg treatment as a transition from methadone; he immediately reported improvement in depressive symptoms and a reduction in pain. He was titrated on BPN-NAL and continued to report diminished pain and resolution of depression. Furthermore, his irritability was lessened and he newly cooperated with staff, participating in unit activities. Upon discharge, he exhibited stable mood, adequate pain control and the elimination of suicidal thoughts as well as a proactive drive for substance abuse treatment.This case describes the significance of BPN on relieving psychic pain and stabilizing mood in a chronically suicidal patient. We speculate that BPN's pharmacokinetic properties terminate the cycle of short-term opioid-induced analgesia and euphoria with opioid withdrawal-induced hyperalgesia and dysphoria. This results in a steady treatment of pain, as well as maintaining the dopaminergic system, symptomatically translating to mood stabilization and annulling suicidal ideation.
View details for DOI 10.1017/S1092852920000875
View details for PubMedID 32331017
Gastaut-Geschwind Syndrome, Faciobrachial Dystonic Seizure, and Autoimmune Limbic Encephalitis.
Case reports in psychiatry
2018; 2018: 3835819
Here we report a case of a 55-year-old male who had presented with recent falls and behavioral changes, including a heightened religious preoccupation, hypergraphia, and paranoid ideations. He was initially treated for psychosis but soon exhibited absence-like seizures, which were consistent with faciobrachial dystonic seizures. Workup for underlying infectious, immunodeficiency, and autoimmune causes revealed antibodies towards the leucine-rich glioma inactivated subunit of the voltage-gated potassium complex. The patient was treated with steroids and intravenous immune globulin with symptomatic relief. In retrospect, the patient met criteria for Gastaut-Geschwind (GG) syndrome, with notable features of hypergraphia and hyperreligiosity. This case illustrates how the GG syndromal pattern contributes to the suspicion of autoimmune limbic encephalitis and may expedite diagnosis and prevent the accumulation of disability.
View details for DOI 10.1155/2018/3835819
View details for PubMedID 30631627
View details for PubMedCentralID PMC6304652
Prediction of suicidal behavior in high risk psychiatric patients using an assessment of acute suicidal state: The suicide crisis inventory.
Depression and anxiety
2017; 34 (2): 147–58
We have developed the Suicide Crisis Inventory (SCI) to evaluate the intensity of the Suicidal Crisis Syndrome, an acute state hypothesized to precede suicide attempt. The psychometric properties of the SCI, including predictive validity for suicidal behavior (SB), were assessed.Adult psychiatric patients (n = 201) hospitalized for high suicide risk were assessed. Logistic regression models assessed the SCI's predictive validity for SB in the 4-8 weeks following hospital discharge and its incremental predictive validity over traditional risk factors (n = 137, 64% f/u rate). Internal structure, reliability, convergent and discriminant validity, and state versus trait properties were also assessed.The SCI had excellent internal consistency (Cronbach's α 0.970). The SCI total score at discharge predicted short-term SB with 64% sensitivity 88% specificity (OR = 13, P = .003) at its optimal cut score. In a test of its incremental predictive validity, SCI total score at discharge improved prediction of SB over traditional risk factors (Chi-squared 5.597, P = .024, model P = .001), with AOR 2.02 (P = .030). The SCI admission versus discharge test-retest reliability and score distributions showed it to be an acute state measure.The SCI was predictive of future SB in high-risk psychiatric inpatients during the crucial weeks following their hospital discharge. Further validation in diverse patient populations is needed.
View details for DOI 10.1002/da.22559
View details for PubMedID 27712028
- The Use of Colchicine in Respiratory Diseases CURRENT RESPIRATORY MEDICINE REVIEWS 2013; 9 (5): 300–304
- The Use of Interferons in Respiratory Diseases CURRENT RESPIRATORY MEDICINE REVIEWS 2013; 9 (5): 318–22
- Gold Salts Therapy in Respiratory Diseases CURRENT RESPIRATORY MEDICINE REVIEWS 2013; 9 (5): 328–33
DNA branch nuclease activity of vaccinia A22 resolvase.
The Journal of biological chemistry
2007; 282 (48): 34644–52
DNA replication, recombination, and repair can result in formation of diverse branched DNA structures. Many large DNA viruses are known to encode DNA branch nucleases, but several of the expected activities have not previously been found among poxvirus enzymes. Vaccinia encodes an enzyme, A22 resolvase, which is known to be active on four-stranded DNA junctions (Holliday junctions) or Holliday junction-like structures containing three of the four strands. Here we report that A22 resolvase in fact has a much wider substrate specificity than previously appreciated. A22 resolvase cleaves Y-junctions, single-stranded DNA flaps, transitions from double strands to unpaired single strands ("splayed duplexes"), and DNA bulges in vitro. We also report site-directed mutagenesis studies of candidate active site residues. The results identify the likely active site and support a model in which a single active site is responsible for cleavage on Holliday junctions and splayed duplexes. Lastly, we describe possible roles for the A22 resolvase DNA-branch nuclease activity in DNA replication and repair.
View details for DOI 10.1074/jbc.M705322200
View details for PubMedID 17890227