title: Treatment with clomethiazole is associated with lower rates of premature discharge during alcohol withdrawal.
abstract: BACKGROUND
  Numerous investigations have shown that premature discharge against medical advice from alcohol detoxification treatment is associated with poor outcome. The aim of the present study was to assess the risk of different possible influencing factors.
  
  
  METHODS
  168 in-patients admitted for detoxification treatment were included in the study. All patients were detoxified using clome-thiazole and/or carbamazepine in individual, symptom-triggered dosages. Possible influencing factors were recorded using a standardised interview.
  
  
  RESULTS
  Cox regression revealed a lower risk of premature discharge being significantly asso-ciated with few preceding withdrawals, intoxication at admission and treatment with clomethiazole. Kaplan-Meier survival statistics showed a significantly lower risk only for being treated with clomethiazole (premature discharge until day 7: chi2=25.07; p<0.001; premature discharge until day 14: chi2=5.19; p=0.023). Other included demographic factors like daily intake of ethanol before admission, duration of alcohol dependence, age or smoking status were not associated with the risk of premature discharge.
  
  
  CONCLUSIONS
  The present findings show that pharmacotherapy with clomethiazole may positively influence the risk of premature discharge. This might be a consequence of the psychoactive properties of the drug which leads to positive reinforcement.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Erlangen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Hillemacher
authors.forename: C
authors.initials: C
authors.lastname: Weinland
authors.forename: A
authors.initials: A
authors.lastname: Heberlein
authors.forename: J
authors.initials: J
authors.lastname: Wilhelm
authors.forename: K
authors.initials: K
authors.lastname: Bayerlein
authors.forename: J
authors.initials: J
authors.lastname: Kornhuber
authors.forename: H
authors.initials: H
authors.lastname: Frieling
authors.forename: S
authors.initials: S
authors.lastname: Bleich
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000188:drug therapy* / Q000401:mortality; D002719:Chlormethiazole / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012044:Regression Analysis; D016019:Survival Analysis
chemical_list: D018696:Neuroprotective Agents; D002719:Chlormethiazole