Croissant B, Loeber S, Diehl A, Nakovics H, Wagner F, Kiefer F, Mann K
Department of Psychiatry, Psychotherapy and Psychosomatics, Teaching Hospital Sigmaringen, University of Tuebingen, Germany.
Pharmacopsychiatry. 2009 Sep;42(5):175-81. doi: 10.1055/s-0029-1202264. Epub 2009 Sep 1.
Oxcarbazepine (OXC), a derivative of Carbamazepine (CBZ), may represent a solution to metabolic and side effects of CBZ treatment due to the fact that renal excretion is its major route of elimination. The goal of the study is to compare the efficacy and tolerability of OXC/Tiaprid (TIA) combination therapy to the well established Clomethiazole (CLO) therapy in an inpatient setting.
To investigate the efficacy of OXC/TIA in terms of lower alcohol withdrawal symptoms and better tolerability, 56 alcohol-dependent patients participated in a randomized open-label trial, where OXC/TIA and CLO treatments were compared.
Following admission, we observed that severity of alcohol withdrawal syndrome was comparable between OXC/TIA and CLO-patients. Overall tolerability was good. However, significantly more patients in the OXC/TIA-group (48.1%) displayed no AE compared to the CLO-group (24.1%). We found no significant differences between groups regarding total number of recorded adverse events (AEs).
OXC/TIA inpatient therapy proved to be as effective and participants demonstrated the same tolerance as with CLO. In medication-based alcohol withdrawal, OXC/TIA could have the potential to become a promising alternative for alcohol dependent patients unable to undergo inpatient withdrawal therapy with CLO. Our findings further indicate that it could be worthwhile testing OXC/TIA in alcohol withdrawal in daily care units and outpatient settings. This is an important question for national health care services, since outpatient therapy is more and more asked for as alternative to inpatient settings.
奥卡西平(OXC)是卡马西平(CBZ)的衍生物,由于其主要通过肾脏排泄,可能是解决CBZ治疗的代谢问题和副作用的一种方法。本研究的目的是在住院环境中比较奥卡西平/硫必利(TIA)联合治疗与成熟的氯美噻唑(CLO)治疗的疗效和耐受性。
为了研究奥卡西平/硫必利在减轻酒精戒断症状和提高耐受性方面的疗效,56名酒精依赖患者参与了一项随机开放标签试验,比较了奥卡西平/硫必利和氯美噻唑的治疗效果。
入院后,我们观察到奥卡西平/硫必利组和氯美噻唑组患者的酒精戒断综合征严重程度相当。总体耐受性良好。然而,与氯美噻唑组(24.1%)相比,奥卡西平/硫必利组中无不良事件的患者显著更多(48.1%)。我们发现两组在记录的不良事件总数方面没有显著差异。
奥卡西平/硫必利住院治疗被证明是有效的,参与者表现出与氯美噻唑相同的耐受性。在基于药物的酒精戒断治疗中,奥卡西平/硫必利有可能成为无法接受氯美噻唑住院戒断治疗的酒精依赖患者的一种有前景的替代方案。我们的研究结果进一步表明,在日间护理单位和门诊环境中对奥卡西平/硫必利进行酒精戒断测试可能是值得的。这对国家医疗服务来说是一个重要问题,因为门诊治疗越来越多地被要求作为住院治疗的替代方案。