title: A double-blind randomized placebo-controlled trial of lofexidine in alcohol withdrawal: lofexidine is not a useful adjunct to chlordiazepoxide.
abstract: Lofexidine is an alpha-adrenoceptor agonist which has proved useful in opiate withdrawal and which, through its attenuation of noradrenergic activity, might be a valuable adjunct in the management of alcohol withdrawal. The objective of this study was to compare the clinical effectiveness and patient retention with adjunctive lofexidine versus placebo in the treatment of alcohol withdrawal under chlordiazepoxide cover. This was done in a prospective double-blind randomized placebo-controlled trial with 72 alcohol-dependent adults referred and admitted for in-patient alcohol detoxification. The adjunctive lofexidine group experienced significantly more severe withdrawal symptoms, greater hypotensive problems, more adverse effects, and no better rates of retention in treatment. Lofexidine provides no discernible benefit as an adjunctive medication (to chlordiazepoxide) in alcohol detoxification and, on the basis of our study, appears to be contra-indicated.
authors.affiliation: National Addiction Centre, Institute of Psychiatry, King's College London and The Maudsley Hospital, 4 Windsor Walk, London SE5 8AF, UK.
authors.forename: F
authors.initials: F
authors.lastname: Keaney
authors.forename: J
authors.initials: J
authors.lastname: Strang
authors.forename: M
authors.initials: M
authors.lastname: Gossop
authors.forename: E J
authors.initials: EJ
authors.lastname: Marshall
authors.forename: M
authors.initials: M
authors.lastname: Farrell
authors.forename: S
authors.initials: S
authors.lastname: Welch
authors.forename: B
authors.initials: B
authors.lastname: Hahn
authors.forename: A
authors.initials: A
authors.lastname: Gonzalez
mesh_terms: D000437:Alcoholism / Q000188:drug therapy*; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002707:Chlordiazepoxide / Q000627:therapeutic use*; D003000:Clonidine / Q000031:analogs & derivatives / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010919:Placebos; D011446:Prospective Studies; D012720:Severity of Illness Index; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy*
chemical_list: D014151:Anti-Anxiety Agents; D009292:Narcotic Antagonists; D010919:Placebos; D002707:Chlordiazepoxide; D003000:Clonidine; C025655:lofexidine