title: Levetiracetam as adjunctive therapy for acute alcohol withdrawal syndrome in hospitalized patients.
abstract: BACKGROUND
  Benzodiazepines are often considered the standard of care for managing symptoms of acute alcohol withdrawal syndrome. Because of potential adverse effects, other agents have been evaluated in this patient population. Previous studies have produced mixed results on the efficacy of levetiracetam in alcohol withdrawal.
  
  
  OBJECTIVE
  The objective of this study was to determine whether adjunctive levetiracetam reduces the amount of symptom-triggered benzodiazepines required by patients experiencing symptoms of alcohol withdrawal.
  
  
  METHODS
  We conducted a retrospective chart review of patients who experienced symptoms of alcohol withdrawal while hospitalized. The outcomes of patients who received adjunctive levetiracetam were compared with those of patients who received only the standard of care (control group).
  
  
  RESULTS
  Two hundred fifty patients (125 in each cohort) were included. No significant differences were found in the benzodiazepine requirements of the 2 cohorts. The control group required a median average daily dose of 2.0 mg of lorazepam (range, 0.1-17 mg/d) compared with the levetiracetam group, which required a median average daily dose of 1.3 mg of lorazepam (range, 0.0-53.5 mg/d) (P = 0.09). The patients in the control group required a median total of 6 mg of lorazepam during their hospitalization compared with a median total of 5.5 mg in the levetiracetam group. Both cohorts had a median length of stay of 3 days, although those in the levetiracetam group had a shorter length of intensive care unit stay and spent less time mechanically ventilated.
  
  
  CONCLUSIONS
  The adjunctive use of levetiracetam does not significantly reduce the benzodiazepine requirements of patients experiencing symptoms of alcohol withdrawal in the inpatient setting.
authors.affiliation: From the *Pharmacy Services, Mayo Clinic, Rochester, MN; †Department of Pharmacy, Gundersen Health System; and ‡Department of Medical Research, Gundersen Medical Foundation, La Crosse, WI.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Youland
authors.forename: Ryan F
authors.initials: RF
authors.lastname: Miller
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Mahoney
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Borgert
authors.forename: Jacob D
authors.initials: JD
authors.lastname: Gundrum
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D000927:Anticonvulsants / Q000008:administration & dosage*; D001569:Benzodiazepines / Q000008:administration & dosage*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives*; D012189:Retrospective Studies; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D000927:Anticonvulsants; D001569:Benzodiazepines; D000077287:Levetiracetam; D010889:Piracetam