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Comparative Study
. 2025 Mar;275(2):573-579.
doi: 10.1007/s00406-024-01835-7. Epub 2024 Jun 8.

Naturalistic comparison of clomethiazole and Diazepam treatment in alcohol withdrawal: effects on oxidative stress, inflammatory cytokines and hepatic biomarkers

David Strischewski  1   2   3 , Amira Kalmar  1   2 , Paul C Guest  1   2   4 , Henrik Dobrowolny  1   2 , Gabriela Meyer-Lotz  1   2 , Conrad J Schiffner  1   2   5 , Wolfgang Jordan  6   7 , Ulf J Müller  1   2   8 , Katrin Borucki  9 , Michael Böttcher  10 , Borna Relja  11 , Johann Steiner  12   13   14   15   16
Affiliations
Comparative Study

Naturalistic comparison of clomethiazole and Diazepam treatment in alcohol withdrawal: effects on oxidative stress, inflammatory cytokines and hepatic biomarkers

David Strischewski et al. Eur Arch Psychiatry Clin Neurosci. 2025 Mar.

Abstract

Ethanol is metabolized by alcohol dehydrogenase to acetaldehyde and induces cytochrome P450 2E1 (CYP2E1), which generates reactive oxygen species that cause inflammatory liver damage. Clomethiazole, a drug approved for alcohol withdrawal treatment (AWT) in some European countries, inhibits CYP2E1. We hypothesized that clomethiazole would lead to a faster reduction in oxidative stress, inflammatory cytokines, and liver enzymes compared to diazepam treatment. We analysed respective biomarkers in 50 patients undergoing AWT and 25 healthy individuals but found no statistical difference between the two medication groups over 3-5 days. Hence, our hypothesis was not confirmed during this observation period.

Keywords: Alcohol detoxification; Alcohol withdrawal treatment; Carbohydrate-deficient transferrin; Clomethiazole; Diazepam; Dityrosine; Ethyl glucuronide; Inflammation; Malondialdehyde; Phosphatidylethanol; Transaminases.

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Conflict of interest statement

Declarations. Conflict of interest: None of the authors declare any competing interests. The study design, data collection, interpretation of results, and manuscript preparation were not influenced by the funding source. Ethics approval: Ethics Committee of the Otto von Guericke University in Magdeburg (reference number 80/17).

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