Treatment of Alcohol Withdrawal Syndrome with Gabapentin

Abstract

Four in-patients with moderate alcohol-withdrawal syndromes benefited from treatment with gabapentin administered in an add-on fashion to clomethiazole. In comparison with the amount of clomethiazole required as estimated using a specially developed score during previous detoxifications of these patients at our hospital, gabapentin (400 mg q.i.d.) clearly reduced the amount of clomethiazole needed now Gabapentin, an anticonvulsant with favorable pharmacokinetic properties and tolerability, and with no known risk of dependence, may therefore be a useful new drug in the treatment of alcohol withdrawal. We believe that the potential value of gabapentin in alcohol withdrawal deserves further controlled studies.

Novel Therapeutic Strategies for Alcohol and Drug Addiction: Focus on GABA, Ion Channels and Transcranial Magnetic Stimulation

“…The pharmacodynamics and pharmacokinetics of gabapentin suggest this drug could be well suited to treat AWS (Bonnet et al, 1999). On the basis of promising data from animal experiments (Watson et al, 1997;Bailey et al, 1998;Dooley et al, 2000), preliminary clinical studies were designed to establish the possible efficacy of gabapentin in the treatment of alcohol-dependent patients affected by AWS.…”

“…On the basis of promising data from animal experiments (Watson et al, 1997;Bailey et al, 1998;Dooley et al, 2000), preliminary clinical studies were designed to establish the possible efficacy of gabapentin in the treatment of alcohol-dependent patients affected by AWS. Open-label studies suggest a generally positive effect of gabapentin in AWS (Myrick and Anton, 1998;Bonnet et al, 1999Bonnet et al, , 2003Bonnet et al, , 2010Chatterjee and Ringold, 1999;Bozikas et al, 2002). A retrospective study analyzed both out-and inpatients treated with gabapentin (starting dose 1200 mg daily) in the treatment of AWS.…”

Cellular and Behavioral Interactions of Gabapentin with Alcohol Dependence

“…Gabapentin has been used effectively in the treatment of alcohol withdrawal in alcoholics (Bonnet et al, 1999(Bonnet et al, , 2007Bozikas et al, 2002;Gentry et al, 2002;Voris et al, 2003;Book and Myrick, 2005;Mariani et al, 2006;Myrick et al, 2007) and has a selective action in decreasing the convulsive and anxiety-related signs of ethanol withdrawal in mice (Watson et al, 1997). Gabapentin decreases ethanol-induced anxiety-like behavior in the elevated plus maze, but has no effect on motor coordination or spontaneous locomotor activity in control mice (Watson et al, 1997).…”

Examination of the Evidence for Off-Label Use of Gabapentin

“…62 There was no mention of gabapentin in this guideline since published reports of gabapentin for these indications are limited to case reports, open-label studies, and anecdotal letters. [63][64][65][66][67] Thus, gabapentin cannot be recommended for use in any aspect of the management of alcohol withdrawal seizures, either as initial or add-on therapy.…”