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Treatment of alcohol withdrawal syndrome with carbamazepine, gabapentin, and nitrous oxide.

PURPOSE: To evaluate the potential use of carbamazepine, gabapentin, and nitrous oxide as alternatives to symptom-triggered benzodiazepine administration for the treatment of alcohol withdrawal syndrome (AWS), a literature review was conducted. SUMMARY: English-language reports of clinical trials of...

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Published in:American Journal of Health-System Pharmacy Vol. 65; no. 11; pp. 1039 - 1048
Main Authors: Prince V, Turpin KR
Format: Journal Article
Published: Oxford University Press / USA 6/1/2008
Online Access:View this record in EBSCOhost
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      dt: 6/1/2008
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      pub: Oxford University Press / USA
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        atl: Treatment of alcohol withdrawal syndrome with carbamazepine, gabapentin, and nitrous oxide.
      aug:
        au:
          Prince V
          Turpin KR
        affil: McWhorter School of Pharmacy, Samford University, Birmingham, AL 35229, USA.
      sug:
        subj:
          Acids, Carbocyclic Therapeutic Use
          Ethanol Adverse Effects
          Amines Therapeutic Use
          Analgesics, Nonnarcotic Therapeutic Use
          Anticonvulsants Therapeutic Use
          Carbamazepine Therapeutic Use
          GABA Therapeutic Use
          Nitrous Oxide Therapeutic Use
          Substance Withdrawal Syndrome Drug Therapy
          Substance Withdrawal Syndrome Etiology
          United States
      ab: PURPOSE: To evaluate the potential use of carbamazepine, gabapentin, and nitrous oxide as alternatives to symptom-triggered benzodiazepine administration for the treatment of alcohol withdrawal syndrome (AWS), a literature review was conducted. SUMMARY: English-language reports of clinical trials of these agents in AWS, particularly trials that compared them with benzodiazepines or anticonvulsants or used them as benzodiazepine-sparing therapy, were reviewed. Six randomized, double-blind trials compared carbamazepine with agents used in the United States. The results suggest that carbamazepine may be useful for this indication, particularly in outpatient settings, although adverse effects and drug interactions may limit its usefulness. The role of gabapentin is unclear because of the lack of randomized, double-blind, controlled trials and the conflicting results of existing case series and open-label trials. Two poorly designed trials of nitrous oxide had conflicting results. CONCLUSION: Because of the limitations in evidence accrued so far, the routine use of carbamazepine and gabapentin for the treatment of AWS cannot be recommended, and nitrous oxide should be avoided for this indication.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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