A double blind randomised comparison of chlordiazepoxide and lorazepam in alcohol withdrawal

Abstract

Aim: To compare the efficacy of lorazepam and chlordiazepoxide in alcohol withdrawal in a double blind design.

Methods: The study sample consisted of 108 consecutive admissions to the de addiction ward, which after informed consent and selection based on inclusion criteria, were randomised to two groups. A comparison of the efficacy of chlordiazepoxide and lorazepam was done post randomisation. The initial withdrawal assessment and subsequent progress of withdrawal were assessed using Clinical Institute Assessment for Alcohol-revised (CIWA-Ar). The rate of withdrawal and total duration of withdrawal were compared among the two groups.

Results: Lorazepam treated group showed a significant difference in the rate of improvement over 48 h compared to chlordiazepoxide group (70.4% vs. 54.8%; p=0.000). The total duration of withdrawal was also significantly lesser with lorazepam (5.6 days vs. 6.7 days; p=0.001).

Conclusion: Lorazepam is more effective than chlordiazepoxide in alcohol withdrawal in both a faster rate in the drop of withdrawal severity and lessening the total duration of withdrawal.

Keywords: CIWA-Ar; Chlordiazepoxide; Dependence; Lorazepam; Withdrawal.