Alcohol Withdrawal Delirium Clinical Trial
Official title:
Treating Alcohol Withdrawal With Oral Baclofen: a Randomized, Double Blind, Placebo Controlled Trial
The purpose of this study is determine if subjects with alcohol withdrawal who receive oral baclofen, plus standard benzodiazepine therapy, will experience less severe withdrawal symptoms than those who receive placebo plus standard benzodiazepine therapy.Subjects with alcohol withdrawal syndrome(AWS)who receive baclofen plus standard benzodiazepine therapy will experience fewer complications of AWS (as measured by use of additional sedatives, restraints, and/or intensive care unit [ICU] admissions) compared with subjects who receive placebo plus standard benzodiazepine therapy.
Alcohol use is ubiquitous in American society. 83% of Americans have ever consumed alcohol,
51% have in the lst month.
The average American consumes 2.18 gallons of ethanol yearly. Alcohol related morbidity and
mortality are staggering problems in the USA. Symptoms of alcohol withdrawal occur because
alcohol is a central nervous system depressant; abrupt withdrawal unmasks compensatory
overactivity of certain parts of the nervous system, including sympathetic autonomic
outflow. 5% of patients who undergo alcohol suffer from Delirium Tremors (DTs), a syndrome
characterized by hallucinations, disorientation, tachycardia, hypertension, low grade fever,
agitation, and diaphoresis.
DTs typically begin between 48-96 hours after the last drink and last 1 to 5 days. DTs
requires hospitalization and vigorous activity in an ICU setting.
The most successful drug treatment for alcohol withdrawal has been found to be the
benzodiazepines.
Symptom triggered treatment was found to be as effective as a fixed dose treatment to result
in less drug being used overall, with a trend toward shorter duration of withdrawal
treatment.
Baclofen is used orally for the treatment of spasticity resulting from multiple sclerosis,
spinal cord injuries/diseases and intrathecally for spasticity related to cerebral palsy,
spinal cord injury, and amyotrophic lateral sclerosis (ALS).
Its proposed benefit in alcohol withdrawal is that it may reduce voluntary alcohol intake,
alcohol craving, and may suppress the intensity of alcohol withdrawal treatment.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Prevention
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