Symptom-triggered versus standard chlormethiazole treatment of inpatient alcohol withdrawal: clinical implications from a chart analysis.
To evaluate clinical effectiveness and safety of 2 different detoxification treatment protocols, a chart analysis of hospital inpatients consecutively admitted for alcohol withdrawal during one year was undertaken. Records of 33 patients receiving symptom-triggered treatment (using a modified version of the revised Clinical Institute Withdrawal Assessment for Alcohol Scale) were compared with those of patients treated by applying a fixed-dose regimen (n = 32). Patients (45.3 +/- 9.8 years, 21% female) of both groups were comparable regarding illness severity, epidemiologic parameters as well as complications during the observed treatment period. Under symptom-triggered therapy, chlormethiazole (CMZ) treatment duration (4.2 +/- 3.5 vs. 7.5 +/- 3.3 days, Mann-Whitney U test: p = 0.0003) and cumulative CMZ dosage (4352 +/- 4589 vs. 9921 +/- 6599 mg, Mann-Whitney U test: p = 0.0004) were significantly reduced. The daily CMZ dose was significantly lower at days 1-5 in the group receiving symptom-triggered treatment. There was no influence of age on the outcome parameters of either treatment group. In conclusion, an individualized symptom-triggered treatment of alcohol withdrawal with CMZ seems to be equally safe but more efficient than a scheduled regimen.
Lange-Asschenfeldt
Christian
C
Department of Psychiatry, University of Mainz, Mainz, Germany. lange@medscape.com
Müller
Matthias J
MJ
Szegedi
Armin
A
Anghelescu
Ion
I
Klawe
Christoph
C
Wetzel
Hermann
H
D000328:Adult; D000437:Alcoholism / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D016009:Chi-Square Distribution; D002719:Chlormethiazole / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D016896:Treatment Outcome
D002719:Chlormethiazole