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Murine Drinking Models in the Development of Pharmacotherapies for Alcoholism: Drinking in the Dark and Two-bottle Choice
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The drug treatment of alcohol withdrawal symptoms: a systematic review

D Williams1, A J McBride

  • 1Ty Bryn, St Cadoc's Hospital, Caerleon, Gwent, UK.

Alcohol and Alcoholism (Oxford, Oxfordshire)
|May 5, 1998
PubMed

Insights

This review found poor methodology in alcohol withdrawal symptom treatment studies. Long-acting benzodiazepines are recommended as the first-choice drug for alcohol withdrawal therapy.

Area of Science:

  • Pharmacology
  • Clinical Medicine
  • Evidence-Based Practice

Background:

  • Alcohol withdrawal syndrome (AWS) is a common clinical challenge requiring effective pharmacotherapy.
  • Numerous pharmacological agents have been investigated for AWS symptom management.
  • Evaluating the quality of evidence for AWS treatments is crucial for clinical decision-making.

Purpose of the Study:

  • To systematically assess the methodological quality of randomized, double-blind, placebo-controlled trials (RCTs) for alcohol withdrawal symptoms.
  • To identify effective pharmacological interventions for AWS based on high-quality evidence.
  • To provide recommendations for future research and clinical practice in AWS management.

Main Methods:

  • A comprehensive literature search was conducted using computer-assisted and cross-reference methods.
  • Included studies were limited to randomized, double-blind, placebo-controlled designs.
  • Methodological quality was systematically assessed, focusing on study populations, control groups, and confounding factors.

Main Results:

  • Fourteen studies evaluating 12 different drugs for AWS were identified.
  • Methodological quality was frequently poor, with under-defined populations and poorly matched controls.
  • While all 12 drugs were reported superior to placebo, only benzodiazepines and chlormethiazole have been consistently replicated.
  • Twelve distinct rating scales were used to measure symptom severity.

Conclusions:

  • Current evidence for the pharmacological treatment of alcohol withdrawal symptoms is often based on methodologically weak studies.
  • Benzodiazepines and chlormethiazole show the most consistent efficacy in AWS treatment.
  • Further high-quality research with standardized methodologies is essential for comparing AWS pharmacotherapies.
  • Long-acting benzodiazepines are suggested as the first-line treatment for alcohol withdrawal symptoms based on available evidence.

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