Alcohol Withdrawal Clinical Trial
Official title:
Comparison of Chlordiazepoxide and Gabapentin for Outpatient Alcohol Detoxification Treatment
A randomized, double-blind controlled trial comparing treatment outcomes between chlordiazepoxide, or gabapentin to treat alcohol withdrawal syndrome in alcohol dependent veteran subjects. The objective of this trial is to compare the safety and effectiveness of these two medications. Intervention is a fixed dose taper of chlordiazepoxide, or gabapentin over 6 days. Subjects will be evaluated for 7-10 days to monitor alcohol abstinence, withdrawal severity scores, adverse events including ataxia, sedation, cognitive function and alcohol craving.
Chlordiazepoxide 25 mg and matching placebo capsules or gabapentin 300 mg and matching
placebo capsules were were used. The chlordiazepoxide/placebo and gabapentin/placebo capsules
were not identical in appearance. Study medications were packaged into a 7-day medication
organizer. The dosing for each subject was either gabapentin 1200mg or chlordiazepoxide 100
mg orally days 1-3, gabapentin 900 mg or chlordiazepoxide 75 mg day 4, gabapentin 600 mg or
chlordiazepoxide 50 mg day 5, and gabapentin 300 mg or chlordiazepoxide 25 mg day 6.
Adherence was assessed by pill counts and serum samples were obtained for study drug
analysis. Serum samples were batched and sent to a contract laboratory so that study
clinicians were blinded to the results until after the trial was completed. Presence of the
assigned study medication in the blood served as a surrogate adherence marker.
Subjects also received prescriptions for daily oral therapeutic multiple vitamin tablets,
folic acid 1 mg, and thiamine 100 mg.
A psychiatric history and physical examination, breath alcohol concentration, vital signs,
CIWA-Ar (alcohol withdrawal scale), and blood chemistry including transaminases and complete
blood cell count were obtained for baseline for all participants. Subjects were seen on
weekdays for clinic follow-up appointments. Assessments performed at each study visit
included CIWA-Ar, ESS (Epworth Sleepiness Scale), PACS (Penn Alcohol Craving Scale), and a
brief examination to document mental status and assess coordination, which included
assessment of stance, tandem gait, Romberg test, pronator drift, toe and heel walk,
rapid-alternating-movements, and point-to-point movements. Breath alcohol concentration (BAC)
was also measured (AlcoSensor, Intoximeters, Inc.) at each visit.
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