Efficacy and safety of levetiracetam for outpatient alcohol detoxification.
BACKGROUND
Anticonvulsant drugs are increasingly being used for alcohol detoxification in in- and outpatient settings. The aim of this study was to examine the efficacy, medical safety and mid-term outcome of levetiracetam, a drug with no marked liver toxicity, for outpatient alcohol detoxification.


METHODS
This was an open-label observational study. After screening eligibility for outpatient alcohol detoxification, patients were seen daily for 5 days and received levetiracetam in a flexible dosage regime between 500 and 4 000 mg/d for a maximum of 7 days. Diazepam was used as a rescue medication. The severity of alcohol withdrawal was evaluated daily using the ALCOHOL WITHDRAWAL SYNDROME SCALE (AWSS). Mid-term treatment outcome was assessed at a 6-month follow-up.


RESULTS
A total number of 131 consecutively admitted alcohol-dependent patients received an outpatient detoxification treatment, 122 (93.1%) completed the programme successfully. The mean initial dose of levetiracetam was 1 850 mg/d. Alcohol withdrawal syndrome as indicated by the AWSS score decreased clearly over 5 days. Overall, the medication was well tolerated. There was no treatment discontinuations due to side effects of levetiracetam. No serious medical complications, especially seizures or deliria, were observed during the detoxification. At the 6-month follow-up, 57 patients (43.5%) were still abstinent. Patients with previous detoxifications had a significant higher risk for relapse (HR=1.88; p=0.016; CI 95%: 1.12-3.14) than patients without previous treatments.


CONCLUSIONS
The findings of this study provide some evidence that levetiracetam is an efficacious and safe treatment option for outpatient alcohol detoxification. Further randomised, controlled trials including mid- and long-term follow-ups are needed to confirm these findings.
Müller
C A
CA
Department of Psychiatry, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany. ch.mueller@charite.de
Schäfer
M
M
Schneider
S
S
Heimann
H M
HM
Hinzpeter
A
A
Volkmar
K
K
Förg
A
A
Heinz
A
A
Hein
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000523:psychology; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D000553:Ambulatory Care / Q000523:psychology*; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011613:Psychotherapy; D012008:Recurrence; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy; D013695:Temperance; D016896:Treatment Outcome; D055815:Young Adult
D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam