Clonidine vs Chlordiazepoxide in the Management of Acute Alcohol Withdrawal Syndrome

Baumgartner, Gregory

doi:10.1001/archinte.1987.00370070037005

Cited by 104 publications

(13 citation statements)

References 31 publications

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“…Serotonin has received increasing attention because of its anxiolytic effects, and for its potential for reduction of ethanol intake. Norepinephrine has received less attention, although α2 adrenoceptor agonists (e.g., clonidine) are used for adjunct treatment of EW [Baumgartner and Rowen, 1987;Cushman, 1987;Robinson et al, 1989;Wilkins et al, 1983]. The antidepressant and/or antipsychotic effects of drugs active at these receptors have also been hypothesized to contribute to their effects on ethanol intake [Gatch and Lal, 1998].…”

Section: Pharmacological Mechanisms Of Ew and Potential Avenues For Tmentioning

confidence: 99%

“…The α 2 agonists clonidine [Baum- gartner and Rowen, 1987;Cushman, 1987;Robinson et al, 1989;Wilkins et al, 1983] and lofexidine [Cushman et al, 1985] are considered to be effective in the management of mild to moderate EW symptoms. It is odd, given the frequency of the use of clonidine in the treatment of EW, that very little research has been conducted on its effects in animal models.…”

Section: Adrenoceptorsmentioning

confidence: 99%

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Animal models of the anxiogenic effects of ethanol withdrawal

Gatch¹,

Lal²

2001

Drug Development Research

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Although anxiety is a major feature of ethanol withdrawal (EW) and much of treatment related to EW is focused on amelioration of the anxiety experienced during EW, less attention has been given to the anxiogenic effects of EW than to the convulsant effects. In this article, we review the animal literature on the anxiogenic effects of EW. Both GABA A and serotonin (5-HT) receptors are important targets in the treatment of anxiety. The roles of each of these two receptors on the anxiogenic effects of EW as well as their potential interrelation are discussed. The contribution of other receptor systems to the modulation of these effects is reviewed. Additionally, males and females show very different levels of anxiety during EW and studies on the role of the HPA axis in mediating these effects are examined. Finally, potential directions for better treatments for EW are discussed. Drug Dev. Res. 54:95-115, 2001.

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Section: Pharmacological Mechanisms Of Ew and Potential Avenues For Tmentioning

confidence: 99%

Section: Adrenoceptorsmentioning

confidence: 99%

Animal models of the anxiogenic effects of ethanol withdrawal

Gatch¹,

Lal²

2001

Drug Development Research

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“…[3][4][5][6][7][8][9] Dexmedetomidine is a centrally acting, relatively selective, alpha2-adrenergic agonist similar to clonidine with sedative and analgesic properties. Dexmedetomidine reduces the stress response, decreases norepinephrine and epinephrine levels, and attenuates increases in heart rate and blood pressure without depressing the respiratory drive.…”

mentioning

confidence: 99%

Retrospective Review of Critically Ill Patients Experiencing Alcohol withdrawal: Dexmedetomidine versus Propofol and/or Lorazepam Continuous Infusions

et al. 2015

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Background: Alcohol withdrawal symptoms can be difficult to manage and may lead to an intensive care unit (ICU) admission. Patients experiencing severe alcohol withdrawal often require high doses of sedatives, which can lead to respiratory depression and the need for endotracheal intubation. Dexmedetomidine, an alpha-2 adrenoreceptor agonist, provides adequate sedation with little effect on respiratory function when compared to other sedatives. Objective: To evaluate sedation with a continuous infusion of dexmedetomidine versus propofol and/or lorazepam in critically ill patients experiencing alcohol withdrawal. Methods: A retrospective chart review was conducted on ICU admissions between March 2002 and April 2009 for alcohol withdrawal patients who necessitated treatment with a continuous infusion of dexmedetomidine, propofol, and/or lorazepam. Primary outcomes included the incidence of mechanical ventilation, length of mechanical ventilation (if applicable), and ICU and hospital length of stay. Results: Fifteen patients were treated with a continuous infusion of dexmedetomidine, and 17 were treated with an infusion of propofol and/or lorazepam. Two patients (13.3%) required intubation and mechanical ventilation in the dexmedetomidine group versus 10 (58.8%) in the propofol and/or lorazepam group (P = .006). Length of stay in the ICU was 53 hours for patients treated with dexmedetomidine versus 114.9 hours in the propofol and/or lorazepam group (P = .016). Hospital length of stay was less for the dexmedetomidine group, 135.8 hours versus 241.1 hours in the propofol and/or lorazepam group (P = .008). Conclusions: Dexmedetomidine use was associated with a decrease in the incidence of endotracheal intubation when used to sedate patients experiencing alcohol withdrawal. Patients transferred to a lower level of care faster and were discharged from the hospital sooner when treated with dexmedetomidine.

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“…Phenytoin and the newer antiepileptic oxcarbazepine have not been shown to be useful in preventing withdrawal seizures [29,30]. β-blockers and other adrenergic agents are often used to treat autonomic symptoms, but their utilization risks masking the severity of withdrawal and may lead to undertreatment [31]. Neuroleptic agents, including phenothiazines and haloperidol, are often used for symptom control but, similarly to adrenergic agents, may cause masking and under treatment.…”

Section: General Approachmentioning

confidence: 99%

Untitled

2017

Int J Psychol Psychoanal

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Clonidine vs Chlordiazepoxide in the Management of Acute Alcohol Withdrawal Syndrome

Cited by 104 publications

References 31 publications

Animal models of the anxiogenic effects of ethanol withdrawal

Animal models of the anxiogenic effects of ethanol withdrawal

Retrospective Review of Critically Ill Patients Experiencing Alcohol withdrawal: Dexmedetomidine versus Propofol and/or Lorazepam Continuous Infusions

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