Benzodiazepines for alcohol withdrawal

Ntais, Christos; Pakos, Emilios E.; Kyzas, Panayiotis; Ioannidis, John P. A.

doi:10.1002/14651858.cd005063.pub2

Cited by 91 publications

(29 citation statements)

References 65 publications

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“…Benzodiazepines are the medications most commonly prescribed to reduce the severity of ethanol withdrawal (Ntais et al, 2005). However, the identification of effective alternatives to benzodiazepine-assisted detoxification is a high priority because (1) there is concern about the abuse potential of benzodiazepines in patients with a propensity for addiction and (2) benzodiazepine prescription may increase the level of alcohol craving and relapse to alcohol use after the initiation of sobriety (Malcolm et al, 2002).…”

mentioning

confidence: 99%

Antiglutamatergic Strategies for Ethanol Detoxification: Comparison With Placebo and Diazepam

Krupitsky

Rudenko

Burakov

et al. 2007

Alcoholism Clin & Exp Res

117

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Background: Benzodiazepines are the standard pharmacotherapies for ethanol detoxification, but concerns about their abuse potential and negative effects upon the transition to alcohol abstinence drive the search for new treatments. Glutamatergic activation and glutamate receptor up-regulation contribute to ethanol dependence and withdrawal. This study compared 3 antiglutamatergic strategies for ethanol detoxification with placebo and to the benzodiazepine, diazepam: the glutamate release inhibitor, lamotrigine; the N-methyl-D-aspartate glutamate receptor antagonist, memantine; and the AMPA/kainite receptor inhibitor, topiramate.Methods: This placebo-controlled randomized single-blinded psychopharmacology trial studied male alcohol-dependent inpatients (n 5 127) with clinically significant alcohol withdrawal symptoms. Subjects were assigned to 1 of 5 treatments for 7 days: placebo, diazepam 10 mg TID, lamotrigine 25 mg QID, memantine 10 mg TID, or topiramate 25 mg QID. Additional diazepam was administered when the assigned medication failed to suppress withdrawal symptoms adequately.Results: All active medications significantly reduced observer-rated and self-rated withdrawal severity, dysphoric mood, and supplementary diazepam administration compared with placebo. The active medications did not differ from diazepam.Conclusions: This study provides the first systematic clinical evidence supporting the efficacy of a number of antiglutamatergic approaches for treating alcohol withdrawal symptoms. These data support the hypothesis that glutamatergic activation contributes to human alcohol withdrawal. Definitive studies of each of these medications are now needed to further evaluate their effectiveness in treating alcohol withdrawal.

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mentioning

confidence: 99%

Antiglutamatergic Strategies for Ethanol Detoxification: Comparison With Placebo and Diazepam

Krupitsky

Rudenko

Burakov

et al. 2007

Alcoholism Clin & Exp Res

117

View full text Add to dashboard Cite

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“…A proper detoxification program and withdrawal management can alleviate future severity of subsequent attacks of the alcohol withdrawal syndrome and help to increase the motivation for comprehensive treatment and abstinence 9,58 . From the pharmacological point of view, benzodiazepines were found to be effective in the treatment of alcohol withdrawal, seizures and delirium tremens prevention [59][60][61] . The existence of a direct antidote for benzodiazepines favors them as a drug of choice 62 .…”

Section: Preventive Measuresmentioning

confidence: 99%

“…11,[63][64][65] ). However, there is a suggestion that even in outpatients, this regimen may help to motivate the patients to start their dependence treatment 60,61 . In a study of 165 patients, the quantity of medication, relapse time in the following 12 months, well-being or treatment satisfaction did not significantly differ in a group of patients treated with FD and those with an ST approach 8 .…”

Section: Preventive Measuresmentioning

confidence: 99%

Alcohol withdrawal delirium - diagnosis, course and treatment

Mainerova

Praško²,

Látalová³

et al. 2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…They are efficacious and safe for primary and secondary seizure prevention. Lorazepam presents the advantage of long-acting anticonvulsant action, compared to diazepam or midazolam [29,30]. Other anticonvulsant drugs associated to BZD should be restricted to the first few days because they do not provide evidence of preventing further withdrawal seizures [27,[31][32][33] and because of the elevated risk of poor therapeutic compliance in this population [32,33].…”

Section: Alcohol and Central Nervous System From Chronic Alcohol Intmentioning

confidence: 99%