The Journal of Informed Pharmacotherapy 2002;10:151.
Reviewer: James McCormack, B.Sc. (Pharm), Pharm. D.
Reviewer's email address: firstname.lastname@example.org
Reviewer's profession/specialty: Associate Editor, Journal of Informed Pharmacotherapy
Daeppen JB, Gache P, Landry U, Sekera E, Schweizer V, Gloor S, Yersin B. Symptom-triggered vs fixed-schedule doses of benzodiazepine for alcohol withdrawal: a randomized treatment trial. Arch Intern Med 2002;162:1093-4 PubMed citation
These investigators evaluated the benefit of using a symptom-triggered versus fixed-schedule doses of benzodiazepines for the prevention of alcohol withdrawal.
117 patients with alcohol dependence who were entering an alcohol dependence program. Their average age was 47 and 77% were male.
Patients were randomized to a fixed schedule of oxazepam 30 mg Q6H for 4 doses followed by 15 mg PO Q6H for 8 doses or a symptom triggered dose (Clinical Institute Withdrawal Assessment for Alcohol scale*) which included a placebo given in a similar regimen as the fixed schedule group plus doses (15-30 mg) of oxazepam as needed based on an alcohol withdrawal scale.
* patients with scores between 8 and 15 received 15 mg of oxazepam, and those with a score higher than 15 received 30 mg of oxazepam
|Patients who received oxazepam (%)||Average total dose of oxazepam (mg)||As needed oxazepam (mg)||Total # of seizures||Hallucinations, DT's||QOL, well being|
|Fixed schedule (n=61)||100||231||7||0||0||NSS|
|Symptom based (n=56)||39||38||38||1||0|
This study shows that treatment of patients who are at risk for alcohol withdrawal do as well on a symptom-triggered regimen of oxazepam as on a fixed-dose schedule. The total amount of oxazepam used is lower in the symptom-triggered group.
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