Sixty-three mainly male alcoholics were randomly assigned to placebo or lofexidine treatment for 48 hr shortly after admission to the hospital. Their starting points were similar regarding their semiquantitative estimates of alcohol withdrawal symptoms (AWS). Their demographics, histories of past alcohol use, physical findings, and laboratory abnormalities usually associated with alcoholism were similar. Starting 3 hr after 0.4 mg of oral lofexidine, which was given every 6 hr as eight doses, the AWS scores were significantly lower than those of the placebo group. Hypotension was the strongest finding. Six placebo recipients had to be prematurely interrupted due to increasing or intolerable alcohol withdrawal symptoms and switched to a benzodiazepine. Only one lofexidine recipient was prematurely interrupted, due to transient hallucinations. The study has a large placebo effect, as both groups of patients rated the treatment process very highly. Lofexidine, an alpha 2-adrenergic agonist, was superior to placebo in alcohol withdrawal. This drug, as with its analogue clonidine, may represent a new and important pharmacological treatment for alcohol withdrawal symptoms.
We assessed the efficacy of lithium carbonate in the treatment of 457 male alcoholics in a double-blind, placebo-controlled Department of Veterans Affairs Cooperative Study. Alcoholics either without depression or with a history of major depression, current major depression, or dysthymic disorder were studied. Two hundred eighty-six alcoholics without depression and 171 alcoholics with depression began the 52-week outpatient study; 172 alcoholics (60.1%) without depression and 108 alcoholics (63.2%) with depression completed the study. Among both all alcoholics who began the study and a subgroup who completed the study, no significant differences between alcoholics who took lithium and those who took placebo were found for the following outcome measures:number of alcoholics abstinent, number of days of drinking, number of alcohol-related hospitalizations, changes in rating of severity of alcoholism, and change in severity of depression. Similarly, no significant differences were found when only the 82 alcoholics compliant in taking lithium and the 89 alcoholics compliant in taking placebo were considered. In our study, lithium treatment did not affect the course of alcoholism in either depressed or nondepressed alcoholics.
Plasma testosterone, FSH, and LH levels were obtained from 25 healthy consecutive heterosexual male mauijuana smoking university students. All values were within the range of normal and the means did not differ significantly from those of 13 normal controls. These data suggest that the casual marijuana smoker (at least one time weekly with an average of 5.1 joints per week) may have plasma testosterone levels which are normal for the time of day and the laboratory.
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