ABSTRACT
In a prospective, double-blind comparison, we assessed the efficacy of transdermal clonidine with that of chlordiazepoxide in the treatment of moderately severe acute alcohol withdrawal syndrome. While having significant withdrawal symptoms, 50 hospitalized men were randomly assigned to receive either transdermal clonidine or chlordiazepoxide over a 4-day study period. Outcome was evaluated daily, medically and psychiatrically, using both objective and subjective measurements for dependent variables. No patient in either study group had seizures or progression to delirium tremens. The group receiving transdermal clonidine had a more significant response globally for the signs and symptoms of alcohol withdrawal, as measured by the Alcohol Withdrawal Assessment Scale. Also, clonidine more effectively lowered elevated systolic and diastolic blood pressure and heart rate. The core target symptom, anxiety, decreased significantly more in the patients receiving transdermal clonidine when measured by the Hamilton Anxiety Rating Scale and its subscale for somatic anxiety. Cognitive function responded equally in both study populations. Clonidine-treated patients reported less diarrhea, dizziness, headache and fatigue, and the chlordiazepoxide-treated patients reported less nausea and vomiting. We conclude that transdermal clonidine is effective treatment for the acute alcohol withdrawal syndrome.
Subject(s)
Chlordiazepoxide/administration & dosage , Clonidine/administration & dosage , Ethanol/adverse effects , Substance Withdrawal Syndrome/drug therapy , Administration, Cutaneous , Adult , Anxiety/drug therapy , Chlordiazepoxide/therapeutic use , Clonidine/therapeutic use , Double-Blind Method , Humans , Male , Middle Aged , Psychological TestsABSTRACT
The findings presented here are from the first reported comparison and double-blind evaluation of 20 patients randomly assigned to either chlordiazepoxide (n = 10) or clonidine (n = 10) for the treatment of acute alcohol withdrawal syndrome. Analysis of the study data demonstrated more favorable scores on tests of alcohol withdrawal symptoms (AWS), and better control of blood pressure, pulse, and respiratory rate with clonidine than with chlordiazepoxide therapy. In all other comparisons, clonidine was at least as efficacious. Clonidine may 'represent a new and possibly even superior pharmacologic treatment in the management of acute alcohol withdrawal syndrome.
Subject(s)
Chlordiazepoxide/therapeutic use , Clonidine/therapeutic use , Ethanol/adverse effects , Substance Withdrawal Syndrome/drug therapy , Acute Disease , Adolescent , Adult , Aged , Chlordiazepoxide/adverse effects , Clinical Trials as Topic , Clonidine/adverse effects , Double-Blind Method , Humans , Male , Middle Aged , Random AllocationABSTRACT
To our knowledge, this is the first reported comparison of clonidine with benzodiazepine in the management of acute alcohol withdrawal syndrome. In a double-blind trial, 61 men experiencing acute alcohol withdrawal were randomly assigned to receive clonidine or chlordiazepoxide over a 60-hour treatment period. Clonidine was more effective than chlordiazepoxide at reducing alcohol withdrawal scale scores, systolic blood pressures, and heart rates over the entire study period. Clonidine was as good as chlordiazepoxide at improving Cognitive Capacity Screening Exam, Hamilton Anxiety Rating Scale, and Self-Rating Scale scores. Adverse drug reactions reported by each group were similar, though less nausea and vomiting were observed in the clonidine group. Clonidine may represent a new alternative agent for the management of acute alcohol withdrawal syndrome.
