Pregabalin, tiapride and lorazepam in alcohol withdrawal syndrome: A multi-centre, randomized, single-blind comparison trial

Giovanni Martinotti, Marco Di Nicola, Alessandra Frustaci, Roberto Romanelli, Daniela Tedeschi, Riccardo Guglielmo, Luigi Guerriero, Angelo Bruschi, Rocco De Filippis, Gino Pozzi, Massimo Di Giannantonio, Pietro Bria, Luigi Janiri

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction The aim of this trial was to compare lorazepam with non-benzodiazepine medications such as pregabalin and tiapride in the treatment of alcohol withdrawal syndrome (AWS). These drugs were chosen for their inhibitorial effects on the hypersecretion of neurotransmitters usually observed in AWS. Craving reduction and improvement of psychiatric symptoms were the secondary end-points. Methods One hundred and ninety subjects affected by current alcohol dependence were considered consecutively: 111 were enrolled and divided into three groups of 37 subjects each. Within a treatment duration of 14 days, medication was given up to the following maximum doses (pregabalin 450 mg/day; tiapride 800 mg/day; lorazepam 10 mg/day). Withdrawal (CIWA-Ar), craving [visual analogue scale (VAS); Obsessive and Compulsive Drinking Scale (OCDS)], psychiatric symptoms [Symptom Check List 90 Revised (SCL-90-R)] and quality of life (QL-index) rating scales were applied. Results On the CIWA-Ar score, all the groups showed a significant reduction between times (P <0.001) with a higher reduction for the pregabalin group (P <0.01) on items regarding headache and orientation. Retention in treatment was lower in the tiapride group (P <0.05), while the number of subjects remaining alcohol free was higher in the pregabalin group (P <0.05). Significant reduction between baseline and the end of the treatment was found in all the groups at the OCDS and the VAS for craving, at the SCL-90-R and QL-index (P <0.001). Discussion All the medications in the trial showed evidence of safety and efficacy in the treatment of uncomplicated forms of AWS, with some particular differences. The efficacy of pregabalin was superior to that of tiapride, used largely in research trials and, for some measures, to that of the 'gold standard', lorazepam. Accordingly, pregabalin may be considered as a potentially useful new drug for treatment of AWS, deserving further investigation.

Original languageEnglish
Pages (from-to)288-299
Number of pages12
JournalAddiction
Volume105
Issue number2
DOIs
Publication statusPublished - Feb 2010

Keywords

  • Alcohol withdrawal
  • Benzodiazepines
  • CIWA-Ar
  • Craving
  • Pregabalin
  • Tiapride

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health
  • Medicine(all)

Fingerprint Dive into the research topics of 'Pregabalin, tiapride and lorazepam in alcohol withdrawal syndrome: A multi-centre, randomized, single-blind comparison trial'. Together they form a unique fingerprint.

Cite this