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Benzodiazepines for alcohol withdrawal.

C Ntais1, E Pakos, P Kyzas

  • 1Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 14 Ch. Zoidi Str., Ioannina, Greece, GR45444. cntais@hol.gr

The Cochrane Database of Systematic Reviews
|July 22, 2005
PubMed
Summary

Benzodiazepines effectively treat alcohol withdrawal symptoms, especially seizures, compared to placebo. Their effectiveness against other drugs is uncertain due to trial variations, but they show similar success rates.

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Area of Science:

  • Pharmacology
  • Neurology
  • Addiction Medicine

Background:

  • Alcohol withdrawal syndrome (AWS) is a common and potentially severe condition following cessation or reduction of alcohol intake in dependent individuals.
  • Benzodiazepines are frequently used to manage AWS symptoms, but their comparative efficacy requires thorough evaluation.

Purpose of the Study:

  • To systematically review and evaluate the effectiveness and safety of benzodiazepines in treating alcohol withdrawal symptoms.
  • To compare benzodiazepines against placebo and other pharmacological interventions for AWS management.

Main Methods:

  • A comprehensive search of major databases (Cochrane Central Register, MEDLINE, EU-PSI PSI-Tri) was conducted for randomized controlled trials (RCTs).
  • RCTs comparing benzodiazepines with placebo, other drugs, or other benzodiazepines were included, with no language or publication restrictions.

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  • Two independent reviewers assessed trial quality and extracted data for analysis.

    • Main Results:

    • Fifty-seven RCTs involving 4,051 participants were analyzed.
    • Benzodiazepines demonstrated significant benefit in preventing alcohol withdrawal seizures compared to placebo (RR 0.16; 95% CI 0.04 to 0.69).
    • Success rates for benzodiazepines were similar to other drugs (RR 1.02; 95% CI 0.92 to 1.12), including anticonvulsants, and they showed benefit against non-anticonvulsants for seizure control.

    Conclusions:

    • Benzodiazepines are effective in managing alcohol withdrawal symptoms, particularly seizures, when contrasted with placebo.
    • Definitive conclusions on the relative efficacy and safety of benzodiazepines versus other drugs are limited by significant heterogeneity in trial interventions and outcome assessments.
    • Available data suggest no prominent differences in success rates between benzodiazepines and other medications for alcohol withdrawal.