Gamma-hydroxybutyric acid versus clomethiazole for the treatment of alcohol withdrawal syndrome in a medical intensive care unit: An open, single-center randomized study

American Journal of Drug and Alcohol Abuse

Volumn 35, Issue 3, 2009, Pages 189-192

  Elsing, Christoph ^a   Stremmel, Wolfgang ^b   Grenda, Uwe ^a   Herrmann, Thomas ^b  

^a St Elisabeth Hospital   (Germany)

^b UNIVERSITY OF HEIDELBERG   (Germany)

Author keywords

Alcohol withdrawal syndrome; Critically ill patients; Gamma hydroxybutyric acid; Medical intensive care unit

Indexed keywords

4 HYDROXYBUTYRIC ACID; CLOMETHIAZOLE; 4-HYDROXYBUTYRIC ACID; BENZODIAZEPINE RECEPTOR AFFECTING AGENT; HYDROXYBUTYRIC ACID;

ADULT; ALCOHOL WITHDRAWAL; ANALYSIS OF VARIANCE; ARTICLE; CLINICAL ARTICLE; CLINICAL TRIAL; COMORBIDITY; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DRUG SAFETY; FEMALE; HOSPITALIZATION; HUMAN; INTENSIVE CARE UNIT; MALE; NAUSEA; OPEN STUDY; OUTCOME ASSESSMENT; RANDOMIZED CONTROLLED TRIAL; RESTLESSNESS; SCORING SYSTEM; SWEATING; TERTIARY HEALTH CARE; TREATMENT OUTCOME; TREATMENT RESPONSE; TREMOR; ALCOHOLISM; COMPARATIVE STUDY; LENGTH OF STAY; MIDDLE AGED; TIME; WITHDRAWAL SYNDROME;

ADULT; ALCOHOLISM; CHLORMETHIAZOLE; COMORBIDITY; FEMALE; GABA MODULATORS; HUMANS; HYDROXYBUTYRATES; INTENSIVE CARE UNITS; LENGTH OF STAY; MALE; MIDDLE AGED; SEVERITY OF ILLNESS INDEX; SUBSTANCE WITHDRAWAL SYNDROME; TIME FACTORS; TREATMENT OUTCOME;

EID: 68249149796     PISSN: 00952990     EISSN: 10979891     Source Type: Journal    
DOI: 10.1080/00952990902933852     Document Type: Article

References (30)

1. O'Conner PG, Schottenfeld RS. Patients with alcohol problems. N Engl J Med 1998; 338:592-602.
2. PabstA,Kraus L. Alkoholkonsum, alkoholbezogene Störungen und Trends. Ergebnisse des Eoidemiologischen Suchtsurveys. Sucht 2006; 54 (Sonderheft 1): S36-S46.
3. Chick J. Delirium tremens. Br Med J 1989; 298:3-4.
4. Mayo-Smith MF. Pharmacological management of alcohol withdrawal. JAMA 1997; 278(2):144-151
5. Spies CD, Dubisz N, Funk W, Blum S, Muller C, Rommelspacher H, et al. Prophylaxis of alcohol withdrawal syndrome in alcohol-dependent patients admitted to the intensive care unit after tumor resection. Br J Anaesth 1995; 75:734-739.
6. Spies C, Dubisz N, Neumann T, Blum S. Therapy of alcohol withdrawal syndrome in intensive care unit patients following trauma: Results of a prospective randomized trial. Crit Care Med 1996; 24:414-422.
7. von Albert HH. Delirium conditions: 2 Therapy. Fortschr Med 1990; 108:161.
8. Wilkins AJ, Jenkins WJ, Steiner JA. Efficacy of clonidine in treatment of alcohol withdrawal state. Psychopharmacology (Berl) 1983; 81:78-80.
9. Dittmar G. Alcohol delirium-Pathogenesis and therapy. Med Klin 1991; 86:607-612.
10. Colombo G, Agabio R, Diaz G, F̀a M, Lobina C, Reali R, Gessa GL. Gamma-hydroxybutyric acid intake in ethanol-preferring sP and - nonpreferring sNP rats. Physiol Behav 1998; 64:197-202.
11. Fadda F, Argiolas A, Melis MR, De Montis G, Gessa GL. Suppression of voluntary ethanol consumption in rats by gammabutyrolactone. Life Sci 1983; 32:1471-1477.
12. Agabio R, Colombo G, Loche A, Lobina C, Pani Mc, Reali R, Gessa GL. Gamma-hydroxybutyric acid reducing effect on ethanol intake: Evidence in favour of a substitution mechanism. Alcohol Alcoholism 1998; 33:465-474.
13. Fadda F, Colombo G, Mosca E, Gessa GL. Suppression by gammahydroxybutyric acid of ethanol withdrawal syndrome in rats. Alcohol Alcoholism 1989; 24:447-451.
14. Gallimbert L, Canton G, Gentile N, Ferri M, Cibin M, Ferrara SD, et al. Gamma-hydroxybutyric acid for treatment of alcohol withdrawal syndrome. Lancet 1989; II:787-789.
15. Gallimberti L, Ferri M, Ferrara SD, Fadda F, Gessa GL. Gamma- Hydroxybutyric acid in the treatment of alcohol dependence: A doubleblind study. Alcohol Clin Exp Res 1992; 16:673-676.
16. Gallimberti L, Spella MR, Soncini CA, Gessa GL. Gamma-hydroxybutyric acid in the treatment of alcohol and heroin dependence. Alcohol 2000; 20(3):257-262.
17. Addolorato G, Balducci G, Capristo E, Attilia Mc, Taggi F, Gasbarrini G, Ceccanti M. Gamma-hydroxybutyric acid (GHB) in the treatment of alcohol withdrawal syndrome: A randomized comparitive study versus benzodiazepine. Alcohol Clin Exp Res 1999; 23(10):1596-1604.
18. Spies CD, Rommelspacher H. Alcohol withdrawal in the surgical patient: Prevention and treatment. Anesth Analg 1999; 88:946-954. (Pubitemid 29168878)
19. Franz M, Dlabal H, Kunz S, Ulferts J, Gruppe H, Gallhofer B. Treatment of alcohol withdrawal:Triapride and carbamazepine versus clomethiazole. A pilot study. Eur Rch Psychiatry Clin Neurosci 2001; 251:185-192.
20. Nimmerrichter AA, Walter H, Gutierrez-Lobos KE, Lesch OM. Double- Blind controlled trial of y-hydroxybutyrate and clomethiazole in the treatment of alcohol withdrawal. Alcohol Alcoholism 2002; 37:67-73.
21. Nava F, Premi S, Manzato E, Campagnola W, Lucchini A, Gessa GL. Gamma-hydroxybutyrate reduces both withdrawal syndrome and hypercortisolism in severe abstinent alcoholic: An open study vs. diazepam. Am J Drug Alcohol Abuse 2007; 33:379-392.
22. Lenzenhuber E. Gamm-hydroxybutyrate for therapy of alcohol withdrawal syndrome in intensive care patients. A comparison between two symptomtriggered therapeutic regimes. Anaesthesist 1999; 48:89-96.
23. Vree TB. Pharmacokinetics of 4-hydroxybutyric acid in man and rhesus monkey. In Anasthesie mit Gamma-Hydroxybuttersaure. Berlin: Springer, 1978.
24. Ferrara SD, Zotti S, Tedeschi L, Frison CT, Castagna F, Gallimberti L, et al. Pharmacokinetics of y-hydroxybutyric acid in alcohol dependent patients after single andrepeated oral doses. Br J Clin Pharmacol 1992; 34:231-235.
25. Palatini P, Tedeschi L, Frison G, Padrini PL, Lordan R, Orlando R, et al. Dose-dependent absorption and elimination of gamma-hydroxybutyric acid in healthy volunteers. Eur J Clin Pharmacol 1993; 45:353-356.
26. Gillmartin JJ, Corris PA, Stone TN,Veale D, Gibson GJ. Effects of diazepam and chlormethiazole on ventilatory control in normal subjects. Br J Clin Pharmacol 1988; 25:766-770.
27. LuchtM, Kuehn KU, Armbruster G, Abraham G, GaensickeM, Barnow S, et al. Alcohol withdrawal treatment in intoxicated vs. non-intoxicated patients: A controlled open-label study with triapicide/carbamazepine, clomethiazole and diazepam. Alcohol Alcoholism 2003; 38:168-175.
28. Pentikainen PJ, Neuvonen PJ, Tarpila S, Syvalathi E. Effect of cirrhosis of the liver on the pharmacokinetics of clomethiazole. Br M Journal 1978; 2:861-863.
29. Spies CD,Otter HE,Huske B, Sinha P, Neumann T,Rettig J, Lenzenhuber E, KoxWJ, SellersEM. Alcohol withdrawal severity is decreased by symptomorientated adjusted bolus therapy in the ICU. Intensive Care Med 2003; 29:2230-2238.
30. Snead OC, Gibson KM. y-hydroxybutyric acid. N Engl J Med 2005; 352:2721-2732.