Myrick Hugh, Taylor Brent, LaRowe Steve, Nguyen Shaun, Boyle Elizabeth, Cochran Kristi, Malcolm Robert
Institute of Psychiatry, MUSC, Charleston, South Carolina 29425, USA.
J Psychoactive Drugs. 2005 Dec;37(4):409-14. doi: 10.1080/02791072.2005.10399814.
Although benzodiazepines are the standard of care in the treatment of alcohol withdrawal, several studies have suggested that anticonvulsants may be equally effective at alleviating alcohol withdrawal symptoms and may pose less of a risk of causing rebound of symptoms which could contribute to relapse. This report compares treatment outcomes for patients (N=13) treated for alcohol withdrawal with either the anticonvulsant tiagabine or the benzodiazepines oxazepam and lorazepam. The Clinical Institute Withdrawal Assessment for Alcohol-revised (CIWA-Ar) was utilized to gauge alcohol withdrawal symptoms over the course of the study. When possible, follow-up data was obtained on alcohol use post-treatment. Both benzodiazepines and tiagabine appeared to reduce CIWA-Ar scores at about the same magnitude. There was a trend for tiagabine patients to have less post-detoxification drinking (Fisher exact test, p = 0.12). The reduction in alcohol withdrawal symptoms and decreased tendency to relapse observed in patients treated with the anticonvulsant tiagabine suggests that a double-blind, placebo controlled trial may be warranted.
尽管苯二氮䓬类药物是治疗酒精戒断的标准药物，但多项研究表明，抗惊厥药物在缓解酒精戒断症状方面可能同样有效，且引发症状反弹导致复吸的风险可能更低。本报告比较了13例接受抗惊厥药物噻加宾或苯二氮䓬类药物奥沙西泮和劳拉西泮治疗酒精戒断的患者的治疗结果。在研究过程中，采用酒精戒断临床研究所修订评估量表（CIWA-Ar）来评估酒精戒断症状。在可能的情况下，获取了治疗后酒精使用情况的随访数据。苯二氮䓬类药物和噻加宾似乎能以大致相同的幅度降低CIWA-Ar评分。噻加宾治疗的患者在脱毒后饮酒较少，不过存在一定趋势（Fisher精确检验，p = 0.12）。接受抗惊厥药物噻加宾治疗的患者酒精戒断症状减轻且复发倾向降低，这表明或许有必要进行一项双盲、安慰剂对照试验。
