Die Behandlung des Alkoholentzugs mit Oxazepam oder Clomethiazol – eine naturalistische Beobachtungsstudie

Abstract

Whilst internationally benzodiazepines are first choice for treatment of alcohol withdrawal syndrome, Germany has a long tradition with clomethiazole. This study explores effectiveness of clomethiazole versus oxazepam in the treatment of alcohol withdrawal syndrome within an observational, stratified, non-inferiority study in routine care. Main outcome criterion was severity of the alcohol withdrawal syndrome (Alcohol Withdrawal Syndrome [AWS]) Scale in the first five days. Additionally, the association between the detoxification protocol (five vs. ten days) and AWS-Score was examined. 453 patients (74.2 % male, average age 47.1 years [± 9.2]) took part; 249 received oxazepam (55.0 %) and 204 clomethiazole (45.0 %). The average duration of inpatient treatment was 14.0 days (± 6.3) in both groups. The average AWS-score was lower in the oxazepam group compared to the clomethiazole group (50.0 [± 26.5] vs. 56.2 [± 31.5]; p < .05; effect size d = - .25). Patients with a shorter detoxification protocol had a lower AWS sum score compared to patients with a longer protocol (p < .001; d = - .46). In treatment of alcohol withdrawal syndrome in routine care oxazepam yields at least comparable results to clomethiazole.

Patient Perspectives on Pharmacotherapy of Alcohol Dependence

“…All participants were inpatients at one psychiatric hospital; hence, the results might not be generalized without caution to a larger in- and outpatient population. However, the sample investigated was similar to samples in other studies with alcohol-dependent patients in inpatient treatment in psychiatric hospitals in Germany regarding age, sex, school education, stable partnership, employment, psychiatric comorbidity, and treatment experience 31 32 . Nevertheless, the urban structure of the recruitment area might influence the results.…”