Comparing the Treatment of Alcohol Withdrawal Syndrome Using Gabapentin Versus Lorazepam

Overview[ - collapse ][ - ]

Purpose The purpose of this study was to evaluate if the medication Gabapentin, which is not approved for the treatment of alcohol withdrawal, is effective in the treatment of alcohol withdrawal syndrome compared to treatment with Lorazepam.
ConditionAlcohol Withdrawal Syndrome(AWS)
InterventionDrug: Gabapentin
Drug: Lorazepam
PhasePhase 2
SponsorNational Institute on Alcohol Abuse and Alcoholism (NIAAA)
Responsible PartyNational Institute on Alcohol Abuse and Alcoholism (NIAAA)
ClinicalTrials.gov IdentifierNCT00229125
First ReceivedSeptember 27, 2005
Last UpdatedSeptember 27, 2005
Last verifiedSeptember 2005

Tracking Information[ + expand ][ + ]

First Received DateSeptember 27, 2005
Last Updated DateSeptember 27, 2005
Start DateJuly 2001
Estimated Primary Completion DateSeptember 2005
Current Primary Outcome Measures
  • Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar).
  • Timeline Followback (TLFB) of drinking behaviors.
Current Secondary Outcome Measures
  • Lower startle reflex magnitudes as an index of CNS excitability or arousal.
  • Lower anxiety (Zung Anxiety Scale) and depression (Beck Depression.
  • Inventory) scores.
  • Subjective reports of sleep quality.

Descriptive Information[ + expand ][ + ]

Brief TitleComparing the Treatment of Alcohol Withdrawal Syndrome Using Gabapentin Versus Lorazepam
Official TitleGabapentin Vs. Lorazepam in Alcohol Withdrawal
Brief Summary
The purpose of this study was to evaluate if the medication Gabapentin, which is not
approved for the treatment of alcohol withdrawal, is effective in the treatment of alcohol
withdrawal syndrome compared to treatment with Lorazepam.
Detailed Description
In the current protocol we evaluated a newer generation anticonvulsant agent, gabapentin.
Gabapentin does not significantly interact with alcohol or other medications, has no abuse
potential, and is excreted by the kidneys and not the liver .

The primary aim of the present application was to evaluate the efficacy of gabapentin in
comparison to lorazepam (as a benzodiazepine gold standard) for the acute outpatient
treatment of alcohol withdrawal (AW). In addition, evaluation of the lorazepam “rebound”
effects observed during the current funding period will be replicated and compared with the
response to gabapentin. Also, the acoustic startle response was used to evaluate the
neurobiological effects of the medications on underlying AW-related CNS excitation, both
during and immediately after AW. In addition, the effect of a history of multiple
detoxifications on parameters such as withdrawal symptoms, CNS excitability, relapse to
alcohol use, craving for alcohol, and response to medication treatment was explored.
Study TypeInterventional
Study PhasePhase 2
Study DesignAllocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
ConditionAlcohol Withdrawal Syndrome(AWS)
InterventionDrug: Gabapentin
Drug: Lorazepam
Study Arm (s)Not Provided

Recruitment Information[ + expand ][ + ]

Recruitment StatusCompleted
Estimated Enrollment160
Estimated Completion DateSeptember 2005
Estimated Primary Completion DateNot Provided
Eligibility Criteria
Inclusion Criteria:

- Subjects must be between 21-70 years of age (both genders will be recruited).

- Subjects must meet DSM-IV criteria for alcohol dependence and uncomplicated alcohol
withdrawal syndrome.

- Subjects must have a mini-mental state score above 26.

- Subjects must be medically stable (not likely to require hospitalization for medical
complications within 10 days).

- Subjects must have a minimum score on the Clinical Institute Withdrawal - -
Assessment for Alcohol-Revised (CIWA-Ar) of 10 within 24 hours of initial assessment.

- Subjects must be medically acceptable for study treatment. Considerations include no
past or present physical disorder that is likely to deteriorate during participation.
No ECG abnormality which would likely worsen during participation and no clinical
laboratory abnormality that would also suggest deterioration during treatment.

- Subjects must exhibit vital signs within the following range: a three-minute sitting
blood pressure in the range of 90-200 mmHg systolic, 60-120 mmHg diastolic and
ventricular rates between 56 and 140 beats per minute.

- Subjects must be suitable for treatment with oral medications.

- Subjects must be able to read, write, and speak English.

- Subjects must have a negative urine drug screen for benzodiazepines or other
sedative-hypnotics, opiates, and stimulants at baseline.

Exclusion Criteria:

- Subjects with current (past month) DSM-IV diagnosis of any other substance dependence
syndrome other than alcohol dependence (excluding nicotine, caffeine, cannabis and
cocaine dependence).

- Use of pharmacological agents within a five half-life period that are known to lower
the seizure threshold or augment or decrease the alcohol withdrawal syndrome
(e.g.,tricyclic antidepressants, anticonvulsants, neuroleptics, benzodiazepines, some
centrally-acting antihypertensives such as beta-blockers, alpha-adrenergic agonists,
and calcium channel antagonists, wellbutrin, buspar, any sedative-hypnotics and
opiates).

- Subjects with a history of idiopathic epilepsy.

- Subjects with diagnosis of schizophrenia, bipolar disorder or dementia.

- Subjects with liver function tests (AST or ALT) 4 times higher than normal. Serum
levels will be drawn upon admission to study and study medications terminated if
necessary.

- History of hepatic encephalopathy, jaundice, ascites, insulin dependent diabetes, or
renal disease.

- Females who are pregnant (as determined by a pregnancy test) or nursing.

- Subjects with known sensitivity or previous adverse reaction to gabapentin,
lorazepam, or other benzodiazepines.

- History of severe GI disease which might render absorption of the medication
difficult or produce medical instability of the patient during detoxification which
would include active peptic ulcer disease, ulcerative colitis, regional colitis, or
evidence by history or physical exam of GI bleeding.

- Subjects who decline or who are not competent to give informed consent.
GenderBoth
Ages21 Years
Accepts Healthy VolunteersAccepts Healthy Volunteers
ContactsNot Provided
Location CountriesUnited States

Administrative Information[ + expand ][ + ]

NCT Number NCT00229125
Other Study ID NumbersNIAAAMAL10761-b
Has Data Monitoring CommitteeNot Provided
Information Provided ByNational Institute on Alcohol Abuse and Alcoholism (NIAAA)
Study SponsorNational Institute on Alcohol Abuse and Alcoholism (NIAAA)
CollaboratorsNot Provided
Investigators Principal Investigator: Robert J. Malcolm, MD Medical University of South CarolinaStudy Director: Carrie Randall, PhD Medical University of South Carolina, Center for Drug and Alcohol Programs
Verification DateSeptember 2005

Locations[ + expand ][ + ]

Medical University of South Carolina - Center for Drug and Alcohol Programs
Charleston, South Carolina, United States, 29425