Gabapentin Versus Lorazepam: Which Drug Is More Effective in the Treatment of Alcohol Withdrawal?
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 withdrawal” (Myrick, Malcolm, Randall, Boyle, Anton, Becker, & Randall, 2009). In recent studies, gabapentin has shown to be effective and safe (Johnson et. al, 2005). The question remains: which drug is more effective in the treatment of alcohol withdrawal?
In an article about alcohol withdrawal requiring massive prolonged benzodiazepine infusion by Hayes, Faestel, Shimamoto, and Holland (2007), the authors discuss a “patient with prolonged alcohol withdrawal requiring massive standing doses of benzodiazepines.” This was a case study in an army medical center in Honolulu. The patient was a 58-year-old alcohol dependent male. The patient was presented to the ICU unit after “an uncomplicated cystoprostatectomy for transitional cell carcinoma of the bladder” (Hayes et. al, 2007). The patient had a prolonged history of alcohol and drug abuse. Last use of alcohol was unknown. Three days after entering ICU, patient had severe agitation. IV lorazepam was started due to persistent agitation. Diazepam was also added to the treatment. Over the course of 37 days the patient had escalating agitation and required continuous IV infusions of both lorazepam and diazepam. No toxicity from the high-dose medication was observed. In summary, the authors
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 withdrawal” (Myrick, Malcolm, Randall, Boyle, Anton, Becker, & Randall, 2009). In recent studies, gabapentin has shown to be effective and safe (Johnson et. al, 2005). The question remains: which drug is more effective in the treatment of alcohol withdrawal?
In an article about alcohol withdrawal requiring massive prolonged benzodiazepine infusion by Hayes, Faestel, Shimamoto, and Holland (2007), the authors discuss a “patient with prolonged alcohol withdrawal requiring massive standing doses of benzodiazepines.” This was a case study in an army medical center in Honolulu. The patient was a 58-year-old alcohol dependent male. The patient was presented to the ICU unit after “an uncomplicated cystoprostatectomy for transitional cell carcinoma of the bladder” (Hayes et. al, 2007). The patient had a prolonged history of alcohol and drug abuse. Last use of alcohol was unknown. Three days after entering ICU, patient had severe agitation. IV lorazepam was started due to persistent agitation. Diazepam was also added to the treatment. Over the course of 37 days the patient had escalating agitation and required continuous IV infusions of both lorazepam and diazepam. No toxicity from the high-dose medication was observed. In summary, the authors
References: Hayes, CPT Patrick C., Faestel, CPT Paul M., Shimamoto, Paige L., & Holland COL Craig J. (2007). Alcohol withdrawal requiring massive prolonged benzodiazepine infusion. MilitaryMedicine,172(5). Johnson, Bankole A., Swift, Robert M., Addolorato, Giovanni, Ciraulo, Domenic A., & Myrick, Hugh (2005). Safety and efficacy of GABAergic medications for treating alcoholism. Alcoholism: Clinical and Experimental Research, 29 (2). Myrick, Hugh, Malcolm, Robert, Randall, Patrick K., Boyle, Elizabeth, Anton, Raymond F., Becker, Howard C., & Randall, Carrie L. (2009). A double-blind trial of gabapentin versus lorazepam in the treatment of alcohol withdrawal. Alcoholism: Clinical and Experimental Research,33(9).