scholarly journals Efficacy and Safety of Pregabalin in the Treatment of Alcohol Withdrawal Syndrome: A Randomized Placebo-Controlled Trial

2012 ◽  
Vol 47 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Anna Förg ◽  
Jakob Hein ◽  
Katharina Volkmar ◽  
Martin Winter ◽  
Christoph Richter ◽  
...  
Keyword(s):  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Controlled Trial ◽  
Alcohol Withdrawal Syndrome ◽  
Efficacy And Safety

scholarly journals Efficacy of transcutaneous electrical acupoint stimulation combined with diazepam for acute alcohol withdrawal syndrome: A double-blind randomized sham-controlled trial

2020 ◽  
Vol 48 (4) ◽  
pp. 030006052091005
Author(s):  
Yun Song ◽  
Xiaobin Xue ◽  
Haibin Han ◽  
Cuiluan Li ◽  
Jia Jian ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Pittsburgh Sleep Quality Index ◽  
Controlled Trial ◽  
Alcohol Withdrawal Syndrome ◽  
Control Group ◽  
Double Blind ◽  
Improve Sleep Quality ◽  
Acupoint Stimulation

Objective To compare the efficacy of transcutaneous electrical acupoint stimulation (TEAS) combined with diazepam against diazepam alone for treatment of acute alcohol withdrawal syndrome (AWS). Methods In this double-blind randomized sham-controlled trial, men with acute AWS were randomly allocated to either a group treated with TEAS combined with diazepam (n = 57) or a control group treated with sham TEAS combined with diazepam (n = 60). Treatment was performed at four acupoints twice a day for 14 days. The Clinical Institute Withdrawal Assessment for Alcohol Scale (CIWA-Ar), visual analogue scale (VAS), Pittsburgh Sleep Quality Index (PSQI) and modified Epworth Sleepiness Scale (mESS) were used to evaluate treatment efficacy. Results All scores improved significantly in both groups during the trial. CIWA-Ar scores were lower in the TEAS group than in the control group from day 3 until the end of observation. VAS and mESS scores were also lower in the TEAS group than in the control group on day 7. VAS and PSQI scores were lower in the TEAS group on day 14. Conclusion Combining diazepam with TEAS may result in milder AWS symptoms than diazepam alone, improve sleep quality and reduce sleepiness.

A Review of Phenobarbital for Alcohol Withdrawal Syndrome

2021 ◽  
Vol 10 ◽  
Author(s):  
Heva Saadatmand ◽  
Pochu Ho
Keyword(s):  
Emergency Department ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Controlled Trial ◽  
Trauma Surgery ◽  
Admission Rate ◽  
Alcohol Withdrawal Syndrome ◽  
Randomized Controlled

Background: Alcohol use disorder represents a serious health problem worldwide which is increasing in pervasiveness. Alcohol withdrawal syndrome is a common clinical problem encountered in emergency departments and inpatient settings, including intensive care units. While benzodiazepines are the most widely used class of medication for the treatment of alcohol withdrawal, in recent years, there is renewed interest in using phenobarbital, a barbiturate, in the treatment of refractory alcohol withdrawal. Objective: This review provides an overview of phenobarbital in the treatment of alcohol withdrawal, as well as clinical outcomes in patients, while also outlining some of the limitations of existing studies in comparing phenobarbital to benzodiazepines. Methods: PubMed, Ovid MEDLINE, and Cochrane databases were searched using the terms phenobarbital, barbiturates, and alcohol withdrawal syndrome. Prospective and retrospective trials comparing phenobarbital with benzodiazepines to treat alcohol withdrawal in English were included. Results: Two prospective randomized controlled and eleven retrospective cohort trials were identified. Phenobarbital is safe alone and as an adjunct to benzodiazepine in the emergency department, intensive care units, general medical units and acute trauma surgery service. In a randomized controlled trial, one dose of phenobarbital in the emergency department significantly reduced the intensive care admission rate. There is some evidence that phenobarbital may be effective in the treatment of benzodiazepine-refractory alcohol withdrawal. Conclusion: Although existing knowledge and practice regarding phenobarbital for the treatment of alcohol withdrawal are increasing, there currently remains limited evidence in support of phenobarbital over benzodiazepines in superior efficacy and outcomes.

Effects of CYP2C19*17 Genetic Polymorphisms on the Steady-State Concentration of Diazepam in Patients With Alcohol Withdrawal Syndrome

2020 ◽  
pp. 001857872093175
Author(s):  
Valentin Yurievich Skryabin ◽  
Mikhail Zastrozhin ◽  
Marco Torrado ◽  
Elena Grishina ◽  
Kristina Ryzhikova ◽  
...  
Keyword(s):  
Steady State ◽  
Genetic Polymorphisms ◽  
Adverse Drug Reactions ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
Efficacy And Safety ◽  
Drug Reactions ◽  
Steady State Concentration ◽  
State Concentration

Background: Diazepam is one of the most widely prescribed tranquilizers for the therapy of alcohol withdrawal syndrome (AWS), which includes the symptoms of anxiety, fear, and emotional tension. However, diazepam therapy often turns out to be ineffective, and some patients experience dose-dependent adverse drug reactions, reducing the efficacy of therapy. Aim: The purpose of our study was to investigate the effects of CYP2C19*17 genetic polymorphisms on the steady-state concentration of diazepam in patients with AWS. Materials and Methods: The study was conducted on 50 Russian male patients suffering from the AWS. For the therapy of psychomotor agitation, anxiety, fear, and emotional tension, patients received diazepam in injections at a dosage of 30.0 mg/day for 5 days. Genotyping was performed by real-time polymerase chain reaction. The efficacy and safety assessment was performed using psychometric scales and scales for assessing the severity of adverse drug reactions. Therapeutic drug monitoring (TDM) was performed using the high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS) method. Results: Based on the results of the study, we revealed the differences in the efficacy of therapy in patients with different CYP2C19 − 806C>T genotypes: (*1/*1) −12.0 [−15.0; −8.0], (*1/*17+*17/*17) −7.0 [−14.0; −5.0], P < .001, as well as the results of TDM: ( CC) 250.70 [213.34; 308.53] ng/mL (*1/*17+*17/*17) 89.12 [53.26; 178.07] ng/mL, P < .001. Conclusion: Thus, our study enrolling 50 patients with AWS, showed the effects of CYP2C19*17 genetic polymorphisms on the efficacy and safety rates of diazepam. Furthermore, we revealed the statistically significant difference in the levels of plasma steady-state concentrations of diazepam in patients carrying different genotypes.

How do CYP2C19*2 and CYP2C19*17 genetic polymorphisms affect the efficacy and safety of diazepam in patients with alcohol withdrawal syndrome?

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Valentin Yu Skryabin ◽  
Mikhail S. Zastrozhin ◽  
Marco V. Torrado ◽  
Elena A. Grishina ◽  
Kristina A. Ryzhikova ◽  
...  
Keyword(s):  
Genetic Polymorphisms ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Safety Assessment ◽  
Alcohol Withdrawal Syndrome ◽  
Efficacy And Safety ◽  
Psychometric Scales ◽  
Therapy Efficacy ◽  
Scale Scores ◽  
Male Patients

Abstract Background Diazepam is one of the most commonly prescribed tranquilizers for therapy of alcohol withdrawal syndrome (AWS). Despite its popularity, there is currently no precise information on the effect of genetic polymorphisms on its efficacy and safety. The objective of our study was to investigate the effect of CYP2C19*2 and CYP2C19*17 genetic polymorphisms on the efficacy and safety of diazepam in patients with AWS. Methods The study was conducted on 30 Russian male patients suffering from the AWS who received diazepam in injections at a dosage of 30.0 mg/day for 5 days. The efficacy and safety assessment was performed using psychometric scales and scales for assessing the severity of adverse drug reactions. Results Based on the results of the study, we revealed the differences in the efficacy of therapy in patients with different CYP2C19 681G>A (CYP2C19*2, rs4244285) genotypes: (CYP2C19*1/*1) −8.5 [−15.0; −5.0], (CYP2C19*1/*2 and CYP2C19*2/*2) −12.0 [−13.0; −9.0], p = 0.021. The UKU scale scores, which were used to evaluate the safety of therapy, were also different: (CYP2C19*1/*1) 7.0 [6.0; 12.0], (CYP2C19*1/*2 and CYP2C19*2/*2) 9.5 [8.0; 11.0], p = 0.009. Patients carrying different CYP2C19 –806C>T (CYP2C19*17, rs12248560) genotypes also demonstrated differences in therapy efficacy and safety rates. Conclusions Thus, the effects of CYP2C19*2 and CYP2C19*17 genetic polymorphisms on the efficacy of diazepam were demonstrated.

scholarly journals The relationship between the CYP2C19*17 genetic polymorphism and the efficacy and safety of diazepam in patients with alcohol withdrawal syndrome

2020 ◽  
Vol 18 (4) ◽  
pp. 119-126
Author(s):  
V. Yu. Skryabin ◽  
M. S. Zastrozhin ◽  
E. A. Grishina ◽  
K. A. Ryzhikova ◽  
V. V. Shipitsyn ◽  
...  
Keyword(s):  
Genetic Polymorphism ◽  
Adverse Drug Reactions ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
Efficacy And Safety ◽  
Drug Reactions ◽  
Specific Hybridization ◽  
Allele Specific ◽  
The Relationship

The aim of our study was to study the relationship between the CYP2C19 genetic polymorphism and the efficacy and safety of diazepam in patients with alcohol withdrawal syndrome in order to develop algorithms for optimizing the therapy of diazepam to reduce the risk of dose-dependent adverse drug reactions and pharmacoresistance.Materials and methods. The study was conducted on 30 Russian male patients suffering from alcohol withdrawal syndrome. For the treatment of anxiety, fear and emotional tension, patients received diazepam in injections at a dosage of 30,0 mg / day for 5 days. Genotyping was performed by real-time polymerase chain reaction with allele-specific hybridization. The efficacy and safety assessment was performed using psychometric scales and scales for assessing the severity of adverse drug reactions: the Clinical Institute Withdrawal Assessment for Alcohol scale, the visual-analogue scale of the craving for alcohol, and the side-effect scale.Results. Based on the results of the study, we revealed the differences in the efficacy of therapy in patients with different CYP2C19 -806C>T genotypes: (CC) –12,0 [–15,0; –8,0], (CT + TT) –7.0 [–14,0; –5,0], p = 0,001. The scores on the UKU scale, which was used to evaluate the safety of therapy, were also different: (CC) 8,0 [6,0; 12,0], (CT + TT) 6,0 [6,0; 12,0], p = 0,006.Conclusion. The relationships between the CYP2C19 genetic polymorphism and the efficacy and safety of diazepam were demonstrated. This should be taken into consideration when prescribing this drug to such patients in order to reduce the risk of adverse drug reactions and pharmacoresistance. 

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