哪些解毒方案对治疗酒精戒断综合征有效？

Which detoxification regimens are effective for alcohol withdrawal syndrome?

机构信息

Department of Family and Preventive Medicine, University of Utah, Salt Lake City, USA.

Family Physicians Inquiries Network.

出版信息

J Fam Pract. 2021 Mar;70(2):E16-E17. doi: 10.12788/jfp.0157.

DOI:10.12788/jfp.0157

PMID:33760908

Abstract

BENZODIAZEPINES REMAIN THE FIRST-LINE REGIMEN FOR ALCOHOL WITHDRAWAL SYNDROME (AWS) AND ARE THE ONLY CLASS MORE EFFECTIVE THAN PLACEBO FOR REDUCING SEIZURE (STRENGTH OF RECOMMENDATION [SOR]: B, BASED ON 3 MEDIUM-QUALITY RANDOMIZED CONTROLLED TRIALS [RCTS]). ANTICONVULSANTS ARE NO MORE EFFECTIVE THAN PLACEBO AT REDUCING SEIZURES (SOR: B, BASED ON 10 MODERATE-QUALITY RCTS). GABAPENTIN REDUCES WITHDRAWAL SYMPTOMS AND IS LESS SEDATING THAN BENZODIAZEPINES (SOR: B, BASED ON 1 MEDIUM-QUALITY RCT). CARBAMAZEPINE ALSO REDUCES WITHDRAWAL SYMPTOMS (SOR: B, BASED ON 3 RCTS). EVIDENCE OF BENZODIAZEPINE SUPERIORITY TO OTHER DRUGS WITH RESPECT TO SAFETY IS LACKING (SOR: A, BASED ON A META-ANALYSIS).

摘要

苯二氮䓬类药物仍然是治疗酒精戒断综合征（AWS）的一线药物，并且是唯一一种比安慰剂更能有效减少癫痫发作的药物（推荐强度[SOR]：B，基于 3 项中等质量的随机对照试验[RCT]）。抗惊厥药在减少癫痫发作方面并不优于安慰剂（SOR：B，基于 10 项中等质量 RCT）。加巴喷丁可减少戒断症状，且镇静作用小于苯二氮䓬类药物（SOR：B，基于 1 项中等质量 RCT）。卡马西平也可减少戒断症状（SOR：B，基于 3 项 RCT）。缺乏关于苯二氮䓬类药物在安全性方面优于其他药物的证据（SOR：A，基于荟萃分析）。