Comparing the Treatment of Alcohol Withdrawal Syndrome Using Gabapentin Versus Lorazepam

This study has been completed.
Sponsor:
Information provided by:
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
ClinicalTrials.gov Identifier:
NCT00229125
First received: September 27, 2005
Last updated: NA
Last verified: September 2005
History: No changes posted
  Purpose

The purpose of this study was to evaluate if the medication Gabapentin, which is not approved for the treatment of alcohol withdrawal, is effective in the treatment of alcohol withdrawal syndrome compared to treatment with Lorazepam.


Condition Intervention Phase
Alcohol Withdrawal Syndrome(AWS)
Drug: Gabapentin
Drug: Lorazepam
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double-Blind
Primary Purpose: Treatment
Official Title: Gabapentin Vs. Lorazepam in Alcohol Withdrawal

Resource links provided by NLM:


Further study details as provided by National Institute on Alcohol Abuse and Alcoholism (NIAAA):

Primary Outcome Measures:
  • Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar).
  • Timeline Followback (TLFB) of drinking behaviors.

Secondary Outcome Measures:
  • Lower startle reflex magnitudes as an index of CNS excitability or arousal.
  • Lower anxiety (Zung Anxiety Scale) and depression (Beck Depression.
  • Inventory) scores.
  • Subjective reports of sleep quality.

Estimated Enrollment: 160
Study Start Date: July 2001
Estimated Study Completion Date: September 2005
Detailed Description:

In the current protocol we evaluated a newer generation anticonvulsant agent, gabapentin. Gabapentin does not significantly interact with alcohol or other medications, has no abuse potential, and is excreted by the kidneys and not the liver .

The primary aim of the present application was to evaluate the efficacy of gabapentin in comparison to lorazepam (as a benzodiazepine gold standard) for the acute outpatient treatment of alcohol withdrawal (AW). In addition, evaluation of the lorazepam “rebound” effects observed during the current funding period will be replicated and compared with the response to gabapentin. Also, the acoustic startle response was used to evaluate the neurobiological effects of the medications on underlying AW-related CNS excitation, both during and immediately after AW. In addition, the effect of a history of multiple detoxifications on parameters such as withdrawal symptoms, CNS excitability, relapse to alcohol use, craving for alcohol, and response to medication treatment was explored.

  Eligibility

Ages Eligible for Study:   21 Years to 70 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Subjects must be between 21-70 years of age (both genders will be recruited).
  • Subjects must meet DSM-IV criteria for alcohol dependence and uncomplicated alcohol withdrawal syndrome.
  • Subjects must have a mini-mental state score above 26.
  • Subjects must be medically stable (not likely to require hospitalization for medical complications within 10 days).
  • Subjects must have a minimum score on the Clinical Institute Withdrawal - - Assessment for Alcohol-Revised (CIWA-Ar) of 10 within 24 hours of initial assessment.
  • Subjects must be medically acceptable for study treatment. Considerations include no past or present physical disorder that is likely to deteriorate during participation. No ECG abnormality which would likely worsen during participation and no clinical laboratory abnormality that would also suggest deterioration during treatment.
  • Subjects must exhibit vital signs within the following range: a three-minute sitting blood pressure in the range of 90-200 mmHg systolic, 60-120 mmHg diastolic and ventricular rates between 56 and 140 beats per minute.
  • Subjects must be suitable for treatment with oral medications.
  • Subjects must be able to read, write, and speak English.
  • Subjects must have a negative urine drug screen for benzodiazepines or other sedative-hypnotics, opiates, and stimulants at baseline.

Exclusion Criteria:

  • Subjects with current (past month) DSM-IV diagnosis of any other substance dependence syndrome other than alcohol dependence (excluding nicotine, caffeine, cannabis and cocaine dependence).
  • Use of pharmacological agents within a five half-life period that are known to lower the seizure threshold or augment or decrease the alcohol withdrawal syndrome (e.g.,tricyclic antidepressants, anticonvulsants, neuroleptics, benzodiazepines, some centrally-acting antihypertensives such as beta-blockers, alpha-adrenergic agonists, and calcium channel antagonists, wellbutrin, buspar, any sedative-hypnotics and opiates).
  • Subjects with a history of idiopathic epilepsy.
  • Subjects with diagnosis of schizophrenia, bipolar disorder or dementia.
  • Subjects with liver function tests (AST or ALT) 4 times higher than normal. Serum levels will be drawn upon admission to study and study medications terminated if necessary.
  • History of hepatic encephalopathy, jaundice, ascites, insulin dependent diabetes, or renal disease.
  • Females who are pregnant (as determined by a pregnancy test) or nursing.
  • Subjects with known sensitivity or previous adverse reaction to gabapentin, lorazepam, or other benzodiazepines.
  • History of severe GI disease which might render absorption of the medication difficult or produce medical instability of the patient during detoxification which would include active peptic ulcer disease, ulcerative colitis, regional colitis, or evidence by history or physical exam of GI bleeding.
  • Subjects who decline or who are not competent to give informed consent.
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00229125

Locations
United States, South Carolina
Medical University of South Carolina - Center for Drug and Alcohol Programs
Charleston, South Carolina, United States, 29425
Sponsors and Collaborators
Investigators
Principal Investigator: Robert J. Malcolm, MD Medical University of South Carolina
Study Director: Carrie Randall, PhD Medical University of South Carolina, Center for Drug and Alcohol Programs
  More Information

No publications provided

ClinicalTrials.gov Identifier: NCT00229125     History of Changes
Other Study ID Numbers: NIAAAMAL10761-b, NIH P-50-AA010761
Study First Received: September 27, 2005
Last Updated: September 27, 2005
Health Authority: United States: Federal Government

Keywords provided by National Institute on Alcohol Abuse and Alcoholism (NIAAA):
Alcohol Withdrawal Syndrome
CIWA-Ar
Acoustic Startle Procedure
Rebound Effect

Additional relevant MeSH terms:
Syndrome
Substance Withdrawal Syndrome
Disease
Pathologic Processes
Substance-Related Disorders
Chemically-Induced Disorders
Mental Disorders
Gabapentin
Lorazepam
Anticonvulsants
Central Nervous System Agents
Therapeutic Uses
Pharmacologic Actions
Antiemetics
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Gastrointestinal Agents
Hypnotics and Sedatives
Central Nervous System Depressants
Anti-Anxiety Agents
Tranquilizing Agents
Psychotropic Drugs
GABA Modulators
GABA Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Analgesics
Sensory System Agents
Antiparkinson Agents

ClinicalTrials.gov processed this record on October 01, 2014