A Retrospective Study of the Adjunctive Use of Gabapentin With Benzodiazepines for the Treatment of Benzodiazepine Withdrawal

Abstract

Benzodiazepine withdrawal is a widespread problem with potentially severe and deadly consequences. Currently, the only medications available for treating benzodiazepine withdrawal are short-acting and long-acting benzodiazepines. Identifying other drugs to help in treating benzodiazepine withdrawal is necessary. Gabapentin, an anxiolytic drug that is also used off-label to treat alcohol withdrawal, is a potential candidate for modulating benzodiazepine withdrawal. Using electronic records from a large inpatient psychiatric facility, a retrospective study of 172 patients presenting with benzodiazepine withdrawal was conducted to determine if the coincidental use of gabapentin for other medical conditions was associated with better outcomes of benzodiazepine withdrawal (N=57 gabapentin, N=115 no gabapentin). The primary outcomes were hospital length of stay and total amount of benzodiazepines given (lorazepam milligram equivalent). In this retrospective analysis of electronic medical record data, the patients experiencing benzodiazepine withdrawal who received gabapentin as an adjunct to the use of benzodiazepines were administered a smaller amount of benzodiazepines and had a shorter length of hospital stay relative to the comparison group who did not receive adjunctive gabapentin. These results suggest the potential use of gabapentin as an adjunct to the use of benzodiazepines for treating benzodiazepine withdrawal. The limitations of this study included a small sample size and variability in medication management strategies across the sample.

Management of alcohol use disorder in patients with chronic liver disease

“…Gabapentin may also be particularly helpful in reducing alcohol use in those with alcohol withdrawal symptoms and has been shown in retrospective studies to reduce inpatient benzodiazepine use for alcohol withdrawal and shorten the length of stay in those admitted for alcohol intoxication and withdrawal. 84 , 87 , 88 Consideration can be given to starting this medication inpatient for patients experiencing mild withdrawal and then continuing it into the outpatient setting for additional anticraving benefits. Varenicline, a nicotinic acetylcholine receptor partial agonist, is FDA-approved for tobacco cessation and has some evidence to suggest that those with both AUD and tobacco cessation saw improved alcohol-associated outcomes as well when on varenicline.…”