Alcohol withdrawal syndrome: clinical and hormonal responses to alpha 2-adrenergic agonist treatment.
Lofexidine (L) was compared to placebo (P) in a random double blind placebo controlled study of 23 healthy alcoholics in withdrawal. In serial alcohol withdrawal syndrome (AWS) scales, P greater than L for first 18 hr. The major changes in AWS were in blood pressure and pulse, while restlessness or diaphoresis did not show faster normalization with L vs. P. Other ratings of withdrawal intensities and craving by patients were similar in both P and L. There were no differences in the rate of patient completion, or appearance of hallucinations by group. Plasma catecholamines were in the high ranges, similar in both groups at 0 and 3 hr, but after 5 hr P greater than L for norepinephrine (but not epinephrine or dopamine). The data suggest L has pharmacological effects on some objective, catecholamine related, components of alcohol withdrawal, with little effect on others. L type treatment of alcoholics in withdrawal is promising, modestly effective and warrants further study.
Cushman
P
P
Department of Medicine, Medical College of Virginia, Richmond.
Sowers
J R
JR
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use*; D000328:Adult; D000437:Alcoholism / Q000097:blood / Q000534:rehabilitation*; D002395:Catecholamines / Q000097:blood; D002986:Clinical Trials as Topic; D003000:Clonidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004311:Double-Blind Method; D000431:Ethanol / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D013375:Substance Withdrawal Syndrome / Q000097:blood / Q000534:rehabilitation*
D000316:Adrenergic alpha-Agonists; D002395:Catecholamines; D000431:Ethanol; D011388:Prolactin; D003000:Clonidine; C025655:lofexidine