A Comparative Study of Fixed Tapering Dose Regimen versus Symptom-triggered Regimen of Lorazepam for Alcohol Detoxification

Aims: The study aimed at comparing the fixed tapering dose and the symptom-triggered regimens of lorazepam for alcohol detoxification. Methods: We carried out a prospective, randomized, double blind controlled trial involving 63 consecutive consenting male patients admitted with diagnosis of uncompl...

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Bibliographic Details
Published in:Alcohol and alcoholism (Oxford) 2014-05, Vol.49 (3), p.287-291
Main Authors: Sachdeva, Ankur, Chandra, Mina, Deshpande, Smita N.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Alcoholism and acute alcohol poisoning
Anticonvulsants - administration & dosage
Anticonvulsants - therapeutic use
Biological and medical sciences
Comparative studies
Delirium
Detoxification
Diagnosis
Dosage
Drug Administration Schedule
Humans
Lorazepam - administration & dosage
Lorazepam - therapeutic use
Male
Medical sciences
Middle Aged
Seizures
Substance Withdrawal Syndrome - drug therapy
Toxicology
Treatment Outcome
Young Adult
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Summary:Aims: The study aimed at comparing the fixed tapering dose and the symptom-triggered regimens of lorazepam for alcohol detoxification. Methods: We carried out a prospective, randomized, double blind controlled trial involving 63 consecutive consenting male patients admitted with diagnosis of uncomplicated alcohol withdrawal. The patients were randomized into two groups based on the type of lorazepam dosage: symptom-triggered (n = 33) and fixed tapering dose regimens (n = 30). Alcohol withdrawal symptoms were rated on CIWA-Ar (Clinical Institute Withdrawal Assessment – Alcohol revised). The main outcome measures were the total amount and duration of lorazepam treatment and the incidence of adverse events or complications. Results: The mean lorazepam dose administered in the symptom-triggered group was significantly lower than in the fixed tapering dose group (9.5 versus 19.9 mg, P < 0.001) and for a significantly shorter duration of time (47.8 versus 146 h, P < 0.001) with more significant results for higher initial CIWA-Ar scores. There were no significant differences between both the groups in terms of the incidence of complications like seizures or delirium tremens. Conclusion: Symptom-triggered lorazepam treatment for alcohol withdrawal resulted in administration of lower total doses of medication for a shorter duration of treatment and was as safe as the fixed tapering dose.
ISSN:0735-0414
1464-3502
DOI:10.1093/alcalc/agt181