Symptom-triggered vs fixed-schedule doses of benzodiazepine for alcohol withdrawal: a randomized treatment trial.

Détails

ID Serval
serval:BIB_888F6374FA3F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Symptom-triggered vs fixed-schedule doses of benzodiazepine for alcohol withdrawal: a randomized treatment trial.
Périodique
Archives of Internal Medicine
Auteur⸱e⸱s
Daeppen J.B., Gache P., Landry U., Sekera E., Schweizer V., Gloor S., Yersin B.
ISSN
0003-9926 (Print)
ISSN-L
0003-9926
Statut éditorial
Publié
Date de publication
2002
Volume
162
Numéro
10
Pages
1117-1121
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
BACKGROUND: In alcohol withdrawal, fixed doses of benzodiazepine are generally recommended as a first-line pharmacologic approach. This study determines the benefits of an individualized treatment regimen on the quantity of benzodiazepine administered and the duration of its use during alcohol withdrawal treatment.
METHODS: We conducted a prospective, randomized, double-blind, controlled trial including 117 consecutive patients with alcohol dependence, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, entering an alcohol treatment program at both the Lausanne and Geneva university hospitals, Switzerland. Patients were randomized into 2 groups: (1) 56 were treated with oxazepam in response to the development of signs of alcohol withdrawal (symptom-triggered); and (2) 61 were treated with oxazepam every 6 hours with additional doses as needed (fixed-schedule). The administration of oxazepam in group 1 and additional oxazepam in group 2 was determined using a standardized measure of alcohol withdrawal. The main outcome measures were the total amount and duration of treatment with oxazepam, the incidence of complications, and the comfort level.
RESULTS: A total of 22 patients (39%) in the symptom-triggered group were treated with oxazepam vs 100% in the fixed-schedule group (P<.001). The mean oxazepam dose administered in the symptom-triggered group was 37.5 mg compared with 231.4 mg in the fixed-schedule group (P<.001). The mean duration of oxazepam treatment was 20.0 hours in the symptom-triggered group vs 62.7 hours in the fixed-schedule group (P<.001). Withdrawal complications were limited to a single episode of seizures in the symptom-triggered group. There were no differences in the measures of comfort between the 2 groups.
CONCLUSIONS: Symptom-triggered benzodiazepine treatment for alcohol withdrawal is safe, comfortable, and associated with a decrease in the quantity of medication and duration of treatment.
Mots-clé
Alcohol Withdrawal Delirium/prevention & control, Alcohol Withdrawal Seizures/prevention & control, Anti-Anxiety Agents/administration & dosage, Double-Blind Method, Drug Administration Schedule, Ethanol/adverse effects, Female, Humans, Male, Middle Aged, Oxazepam/administration & dosage, Prospective Studies, Quality of Life, Statistics, Nonparametric, Substance Withdrawal Syndrome/drug therapy, Substance Withdrawal Syndrome/etiology, Switzerland
Pubmed
Web of science
Open Access
Oui
Création de la notice
25/01/2008 17:13
Dernière modification de la notice
20/08/2019 14:47
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