Gabapentin Versus Lorazepam: Which Drug Is More Effective in the Treatment of Alcohol Withdrawal?

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Alcoholism is a long standing health issue, and there has been ongoing research to seek out drugs that could effectively help to treat alcoholism, acute and long-term. According to an article by Johnson, Swift, Addolorato, Ciraulo, and Myrick (2005), a challenge has been to identify medications that not only reduce the rewarding effects of alcohol, but the dependence, post cessation craving, and the withdrawal craving.
Lorazepam and gabapentin have been used for the detoxification of alcohol dependent patients. Lorazepam is a type of benzodiazepine, an antianxiety medication. Gabapentin is a type of anticonvulsant drug originally used to prevent seizures. “Benzodiazepines represent the standard of care for the treatment of alcohol
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Research was done to compare gabapentin to lorazepam in the treatment of alcohol withdrawal. Myrick, Malcolm, Randall, Boyle, Anton, Becker, and Randall (2009) performed a randomized double-blind treatment on 100 individuals seeking outpatient treatment of alcohol withdrawal with Clinical Institute Withdrawal Assessment for Alcohol-Revised(CIWA-Ar) ratings ≥10. Subjects were either given 2 doses of gabapentin, 900 mg tapering to 600 mg or 1200 mg tapering to 800 mg; or given lorazepam, 6 mg tapering to 4 mg for 4 days. Severity of withdrawal from alcohol was measured by the CIWA-Ar on days 1-4 of treatment and days 5, 7, and 12 post treatment. Verbal reports and breath alcohol levels were measurements of alcohol use. Results showed that CIWA-Ar scores reduced in all groups overtime. High-dose gabapentin statistically did the best but was clinically similar to lorazepam. Lorazepam patients had higher probabilities of drinking on day 2 (the first day the dosage decreased), as well as the second day off the medication. Gabapentin treated groups were less likely to have craving, anxiety and sedation compared to the lorazepam treated groups. Overall, the gabapentin treated group had a less probability of drinking and was well tolerated. Some limitations to the study were that the participants selected had mild to moderate withdrawal severity and were in better general health than patients presenting the ED or hospitals. Also, no placebo group was

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