A retrospective chart review comparing tiagabine and benzodiazepines for the treatment of alcohol withdrawal.
Although benzodiazepines are the standard of care in the treatment of alcohol withdrawal, several studies have suggested that anticonvulsants may be equally effective at alleviating alcohol withdrawal symptoms and may pose less of a risk of causing rebound of symptoms which could contribute to relapse. This report compares treatment outcomes for patients (N=13) treated for alcohol withdrawal with either the anticonvulsant tiagabine or the benzodiazepines oxazepam and lorazepam. The Clinical Institute Withdrawal Assessment for Alcohol-revised (CIWA-Ar) was utilized to gauge alcohol withdrawal symptoms over the course of the study. When possible, follow-up data was obtained on alcohol use post-treatment. Both benzodiazepines and tiagabine appeared to reduce CIWA-Ar scores at about the same magnitude. There was a trend for tiagabine patients to have less post-detoxification drinking (Fisher exact test, p = 0.12). The reduction in alcohol withdrawal symptoms and decreased tendency to relapse observed in patients treated with the anticonvulsant tiagabine suggests that a double-blind, placebo controlled trial may be warranted.
Myrick
Hugh
H
Institute of Psychiatry, MUSC, Charleston, South Carolina 29425, USA. myrickh@musc.edu
Taylor
Brent
B
LaRowe
Steve
S
Nguyen
Shaun
S
Boyle
Elizabeth
E
Cochran
Kristi
K
Malcolm
Robert
R
D020751:Alcohol-Induced Disorders / Q000188:drug therapy*; D000704:Analysis of Variance; D001569:Benzodiazepines / Q000627:therapeutic use*; D003710:Demography; D005260:Female; D018755:GABA Agonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009557:Nipecotic Acids / Q000627:therapeutic use*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy*; D000078308:Tiagabine; D013997:Time Factors
D018755:GABA Agonists; D009557:Nipecotic Acids; D001569:Benzodiazepines; D000078308:Tiagabine