GABAPENTIN AND LORAZEPAM IN OUTPATIENT DETOXIFICATION

酒精戒断综合征（AWS）已经用非常安全和有效的苯二氮卓类药物（BZ）治疗了近40年。在AWS的门诊治疗中，与酒精的相互作用和BZ的滥用责任邀请与不分享这些责任的代理人进行比较。在我们最初的酒精研究中心组成部分比较劳拉西泮（LZ）卡马西平（CBZ），后者是显着更有效地抑制声惊吓反应，焦虑和抑郁症状在治疗过程中。在治疗后7天内，LZ受试者表现出更高水平的AWS症状的多个维度，包括更高的戒断评分，睡眠差，以及比CBZ更大的主观不适。CBZ，在研究中有用，但由于其广泛的相互作用和罕见但严重的毒性，限制了临床应用。在本申请中，我们提出了一项加巴喷丁（GBP，80）与LZ（N=80）在经历AWS的寻求治疗的门诊患者中的双盲对照试验。AWS的多个领域将在五天门诊治疗间隔和七天治疗后阶段进行评估。系列测量包括眨眼声惊吓反应的电生理学测试、由CIWA-Ar评估的总戒断症状、睡眠的主观评估、全身不适、焦虑、抑郁和对额外药物的需要。将比较副作用和安全性。GMP是一种独特的抗惊厥药，不是一种受控物质，很快将成为通用药物，具有良性副作用，与其他药物没有相互作用，与酒精的相互作用有限。将比较副作用和安全性。GBP是一种独特的抗惊厥药，不是一种受管制的物质，很快将成为通用药物，具有良性副作用，与其他药物没有相互作用，与酒精的相互作用有限。如果GBP在治疗AWS方面上级于LZ，则可修改AWS在门诊患者中的管理方式。

The alcohol withdrawal syndrome (AWS) has been treated for nearly forty years with the remarkably safe and effective benzodiazepines (BZs). In the outpatient treatment of AWS, interactions with alcohol and the abuse liability of BZs invite comparisons with agents that do not share these susceptibilities. In our original Alcohol Research Center component comparing Lorazepam (LZ) to Carbamazepine (CBZ), the latter was significantly more effective in suppressing the acoustic startle response, and anxiety and depressive symptoms during treatment. In the immediate seven-day post treatment, LZ subjects showed higher levels of multiple dimensions of AWS symptoms, including higher withdrawal scores, poor sleep, and greater subjective discomfort than CBZ. CBZ, useful in research has limited clinical applications because of its widespread interactions and uncommon but serious toxicities. In the present application, we propose a double-blind controlled trial of gabapentin (GBP, 80) vs. LZ (N=80) in treatment seeking outpatients experiencing AWS. Multiple domains of AWS will be evaluated during a five-day outpatient treatment interval and a seven-day post treatment phase. Serial measures include electrophysiologic tests of eye blink acoustic startle response, aggregate withdrawal symptoms as evaluated by the CIWA-Ar, subjective assessments of sleep, global discomfort, anxiety, depression, and need for additional medications. Side effects and safety will be compared. GMP, a unique anticonvulsant, is not a controlled substance, soon will be generic, has benign side effects, has no interactions with other drugs, and has limited interactions with alcohol. Side effects and safety will be compared. GBP, a unique anticonvulsant, is not a controlled substance, soon will be generic, has benign side effects, has no interactions with other drugs, and has limited interactions with alcohol. Should GBP be superior to LZ for the treatment of AWS, it could revise the way AWS is managed in outpatients.