Pregabalin, tiapride and lorazepam in alcohol withdrawal syndrome: a multi‐centre, randomized, single‐blind comparison trial

Martinotti, Giovanni; Nicola, Marco Di; Frustaci, Alessandra; Romanelli, Roberto Giulio; Tedeschi, D.; Guglielmo, Riccardo; Guerriero, L.; Bruschi, Angelo; Filippis, Rocco de; Pozzi, Gino; Giannantonio, Massimo Di; Bria, Pietro; Janiri, Luigi

doi:10.1111/j.1360-0443.2009.02792.x

Cited by 64 publications

(30 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pregabalin was safe and tolerable and associated with a significant reduction in CIWA-Ar scores and alcohol craving. Second, pregabalin, tiapride, and lorazepam were compared head-to-head for the outpatient treatment of AWS in 111 subjects with DSM-IV-TR [123] diagnoses of alcohol dependence [45]. All medications significantly reduced AWS, with pregabalin demonstrating significantly better treatment for ‘headache’ and ‘orientation’ withdrawal symptoms.…”

Section: Non-benzodiazepine Anticonvulsants (Nbacs) For the Treatmementioning

confidence: 99%

Anticonvulsants for the Treatment of Alcohol Withdrawal Syndrome and Alcohol Use Disorders

et al. 2015

View full text Add to dashboard Cite

Alcoholic patients suffer from harmful allostatic neuroplastic changes in the brain causing an acute withdrawal syndrome upon cessation of drinking followed by a protracted abstinence syndrome and an increased risk of relapse to heavy drinking. Benzodiazepines have long been the treatment of choice for detoxifying patients and managing alcohol withdrawal syndrome (AWS). Non-benzodiazepine anticonvulsants (NBACs) are increasingly being used both for alcohol withdrawal management and for ongoing outpatient treatment of alcohol dependence, with the goal of either abstinence or harm reduction. This expert narrative review summarizes the scientific basis and clinical evidence supporting the use of NBACs in treating AWS and for reducing harmful drinking patterns. There is less evidence in support of NBAC therapy for AWS, with few placebo-controlled trials. Carbamazepine and gabapentin appear to be the most promising adjunctive treatments for AWS, and they may be useful as monotherapy in select cases, especially in outpatient settings and for the treatment of mild-to-moderate low-risk patients with the AWS. The body of evidence supporting the use of the NBACs for reducing harmful drinking in the outpatient setting is stronger. Topiramate appears to have a robust effect on reducing harmful drinking in alcoholics. Gabapentin is a potentially efficacious treatment for reducing the risk of relapse to harmful drinking patterns in outpatient management of alcoholism. Gabapentin's ease of use, rapid titration, good tolerability, and efficacy in both the withdrawal and chronic phases of treatment make it particularly appealing. In summary, several NBACs appear to be beneficial in treating AWS and alcohol use disorders.

show abstract

Section: Non-benzodiazepine Anticonvulsants (Nbacs) For the Treatmementioning

confidence: 99%

Anticonvulsants for the Treatment of Alcohol Withdrawal Syndrome and Alcohol Use Disorders

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Although these drugs have a demonstrated efficacy for acutely treating depressive symptoms, certain of them possess considerable adverse effects due to their antinoradrenergic or antihistaminergic properties. Moreover, the issue of polypharmacotherapy is another point to take into account, given the role of some new generation antipsychotics and mood stabilizers able to treat the major symptoms of insomnia [138][139][140].…”

Section: Discussionmentioning

confidence: 99%

Antidepressants and Sleep: Neurophysiology and Clinical Correlates

Iorio¹,

Marini²,

Acciavatti³

et al. 2012

CPSR

View full text Add to dashboard Cite

Introduction: Depression is a common disorder associated with significant disability and is a substantial burden on the individual, their relatives and friends, and on society as a whole. Sleep disturbances are key features of depressive symptomatology, with more than 80% of depressed patients complaining of poor quality sleep.Methods: The range of available antidepressants is here reviewed in relation to mechanisms of action and the evidence of sleep alteration in patients with depression.Results: The available treatments are largely effective but their use is compromised by poor tolerability and low adherence to treatment. It is also clear that currently used antidepressant agents tend to disrupt sleep architecture. Agomelatine, a novel antidepressant, has been found successful in treating depressed patients. Because of its dual mechanism of action on MT1 and MT2 melatonin receptors in the SCN and its 5-HT2c antagonist properties, agomelatine has been effective in improving both quality of sleep and mood in depressed patients.Conclusions: There is clinical and epidemiological evidence that sleep disturbances in depression constitute a risk factor for poor clinical outcomes. Specifically, insomnia complaints precede the onset and recurrence of depression. For this reason antidepressants with a faster onset of action, with less interferences on sleep architecture would be expected to bring larger numbers of depressed patients to full remission.

show abstract

“…A randomized, single-blind study compared pregabalin with tiapride and lorazepam, for the treatment of alcohol withdrawal syndrome (Table 1) [46]. After 14 days of treatment, all groups showed a significant improvement in withdrawal symptoms, craving, quality of life, and comorbid psychiatric symptoms.…”

Section: Alcohol Withdrawal Symptomsmentioning

confidence: 99%

Pregabalin for the Treatment of Drug and Alcohol Withdrawal Symptoms: A Comprehensive Review

et al. 2016

View full text Add to dashboard Cite

Treatments for physical dependence and associated withdrawal symptoms following the abrupt discontinuation of prescription drugs (such as opioids and benzodiazepines), nicotine, alcohol, and cannabinoids are available, but there is still a need for new and more effective therapies. This review examines evidence supporting the potential use of pregabalin, an α2δ voltage-gated calcium channel subunit ligand, for the treatment of physical dependence and associated withdrawal symptoms. A literature search of the MEDLINE and Cochrane Library databases up to and including 11 December 2015 was conducted. The search term used was ‘(dependence OR withdrawal) AND pregabalin’. No other date limits were set and no language restrictions were applied. Works cited in identified articles were cross-referenced and personal archives of references also searched. Articles were included based on the expert opinions of the authors. There is limited evidence supporting the role of pregabalin for the treatment of physical dependence and accompanying withdrawal symptoms associated with opioids, benzodiazepines, nicotine, cannabinoids, and alcohol, although data from randomized controlled studies are sparse. However, the current evidence is promising and provides a platform for future studies, including appropriate randomized, placebo- and/or comparator-controlled studies, to further explore the efficacy and safety of pregabalin for the treatment of withdrawal symptoms. Given the potential for pregabalin misuse or abuse, particularly in individuals with a previous history of substance abuse, clinicians should exercise caution when using pregabalin in this patient population.

show abstract

Pregabalin, tiapride and lorazepam in alcohol withdrawal syndrome: a multi‐centre, randomized, single‐blind comparison trial

Cited by 64 publications

References 70 publications

Anticonvulsants for the Treatment of Alcohol Withdrawal Syndrome and Alcohol Use Disorders

Anticonvulsants for the Treatment of Alcohol Withdrawal Syndrome and Alcohol Use Disorders

Antidepressants and Sleep: Neurophysiology and Clinical Correlates

Pregabalin for the Treatment of Drug and Alcohol Withdrawal Symptoms: A Comprehensive Review

Contact Info

Product

Resources

About