Gabapentin for Alcohol Withdrawal Syndrome

Overview

About this study

The current "gold-standard" for the management of alcohol withdrawal syndrome (AWS) is symptom-triggered administration of benzodiazepines. This method of treatment has several drawbacks that have been described in the literature. Thus benzodiazepine sparing agents have been evaluated for use in AWS. One of these agents that has not only shown benefit for AWS but also benefits on complete abstinence, reducing a return to heavy drinking, and cravings is gabapentin. In clinical practice at Mayo Clinic gabapentin is used for this purpose. Due to the limited reports of the safety and efficacy of a protocol involving gabapentin for AWS, a study to compare gabapentin to symptom-triggered lorazepam will be completed.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

  1. Prediction of Alcohol Withdrawal Severity Scale (PAWSS) score >4.
  2. Adults age 18 or older.
  3. Sufficient understanding of English.
  4. Hospitalized on Hospital Internal Medicine, Family Medicine, or Generose.

Exclusion Criteria:

  1. Severe renal impairment (estimated CrCl < 30).
  2. Intensive Care Unit (ICU) level of care.
  3. Not responsive due to alcohol intoxication or withdrawal.
  4. Already taking gabapentin more than 300 mg three times a day.
  5. Prescribed pregabalin.
  6. Primary seizure disorder.
  7. Acute benzodiazepine withdrawal.
  8. Concurrent substance use disorders (such as opioid use disorder, stimulant use disorder) if the disorder is assessed to be clinically significant. Cannabis use disorder will be allowed.
  9. Concurrent anticonvulsant medications for psychiatric indications (e.g. bipolar disorder) will be allowed.
  10. Pregnancy.
  11. Involuntary legal status (e.g., on court commitment).
  12. Patients admitted greater than 16 hours prior to potential enrollment.
  13. Patients receiving therapeutic dose of gabapentin (rather than continuation of home dose) prior to enrollment.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status

Rochester, Minn.

Mayo Clinic principal investigator

Ruth DeFoster, M.D.

Closed for enrollment

More information

Publications

  • The prevalence of alcohol use disorders (AUDs) among hospitalized medically ill patients exceeds 40%. Most AUD patients experience uncomplicated alcohol withdrawal syndrome (AWS), requiring only supportive medical intervention, while complicated AWS occurs in up to 20% of cases (i.e. seizures, delirium tremens). We aimed to prospectively test and validate the Prediction of Alcohol Withdrawal Severity Scale (PAWSS), a new tool to identify patients at risk for developing complicated AWS, in medically ill hospitalized patients. Read More on PubMed
  • To review the literature evaluating gabapentin for alcohol withdrawal and dependence. Read More on PubMed
  • This study examined the efficacy of a 28-day gabapentin treatment in reducing alcohol consumption and craving. Read More on PubMed

Additional contact information

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