Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2009 Sep;33(9):1582-8.
doi: 10.1111/j.1530-0277.2009.00986.x. Epub 2009 May 26.

A double-blind trial of gabapentin versus lorazepam in the treatment of alcohol withdrawal

Hugh Myrick  1 , Robert Malcolm, Patrick K Randall, Elizabeth Boyle, Raymond F Anton, Howard C Becker, Carrie L Randall
Affiliations
Randomized Controlled Trial

A double-blind trial of gabapentin versus lorazepam in the treatment of alcohol withdrawal

Hugh Myrick et al. Alcohol Clin Exp Res. 2009 Sep.

Abstract

Introduction: Some anticonvulsants ameliorate signs and symptoms of alcohol withdrawal, but have an unacceptable side effect burden. Among the advantages of using anticonvulsant agents in this capacity is their purported lack of interaction with alcohol that could increase psychomotor deficits, increase cognitive impairment, or increase intoxication. The aim of this study was to evaluate alcohol use and symptom reduction of gabapentin when compared with lorazepam in the treatment of alcohol withdrawal in a double-blinded randomized clinical trial.

Methods: One hundred individuals seeking outpatient treatment of alcohol withdrawal with Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) ratings > or =10 were randomized to double-blind treatment with 2 doses of gabapentin (900 mg tapering to 600 mg or 1200 tapering to 800 mg) or lorazepam (6 mg tapering to 4 mg) for 4 days. Severity of alcohol withdrawal was measured by the CIWA-Ar on days 1 to 4 of treatment and on days 5, 7, and 12 post-treatment and alcohol use monitored by verbal report and breath alcohol levels.

Results: CIWA-Ar scores decreased over time in all groups; high-dose gabapentin was statistically superior but clinically similar to lorazepam (p = 0.009). During treatment, lorazepam-treated participants had higher probabilities of drinking on the first day of dose decrease (day 2) and the second day off medication (day 6) compared to gabapentin-treated participants (p = 0.0002). Post-treatment, gabapentin-treated participants had less probability of drinking during the follow-up post-treatment period (p = 0.2 for 900 mg and p = 0.3 for 1200 mg) compared to the lorazepam-treated participants (p = 0.55). The gabapentin groups also had less craving, anxiety, and sedation compared to lorazepam.

Conclusions: Gabapentin was well tolerated and effectively diminished the symptoms of alcohol withdrawal in our population especially at the higher target dose (1200 mg) used in this study. Gabapentin reduced the probability of drinking during alcohol withdrawal and in the immediate postwithdrawal week compared to lorazepam.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Alcohol withdrawal symptoms: CIWA - Ar score over time. Comparisons: GBP 900mg vs 1200mg: t = 5.83, p = 0.019 GBP 900mg vs Lorazepam: Not significant GBP 1200mg vs Lorazepam: t = 6.86, p = 0.011 * Baseline CIWA-Ar score used as a covariate in the analysis
Figure 2
Figure 2
Probability of drinking during treatment and follow-up.
See this image and copyright information in PMC

References

    1. Anton RF. What is craving? Models and implications for treatment. Alcohol Res Health. 1999;23:165–173. - PMC - PubMed
    1. Baydas G, Sonkaya E, Tuzcu M, Yasar A, Donder E. Novel role of gabapentin in neuroprotection of central nervous system in strepozotocine-induced diabetic rats. Acta Pharmacol Sin. 2005;26(4):417–422. - PubMed
    1. Beck AT, Ward CH, Mendlesohn M, Mock J, Erbaugh J. An inventory for measuring depression. Arc Gen Psychiatry. 1961;4:561–571. - PubMed
    1. Bisaga A, Evans SM. The acute effects of gabapentin in combination with alcohol in heavy drinkers. Drug Alc Dep. 2006;83:25–32. - PubMed
    1. Brower KJ, Myra Kim H, Strobbe S, Karam-Hage MA, Consens F, Zucker RA. A randomized double-blind pilot trial of gabapentin versus placebo to treat alcohol dependence and comorbid insomia. Alcohol Clin Exp Res. 2008;32(8):1429–1438. - PMC - PubMed

Publication types

MeSH terms