A Comparative Study of the Clinical Efficacy and Safety of Lorazepam and Chlordiazepoxide in Alcohol Dependence Syndrome
Background: Currently, benzodiazepines are the preferred drugs in the management of alcohol withdrawal symptoms. Chlordiazepoxide and diazepam, the most frequently used drugs have a long duration of action and are converted to active metabolites in the liver, while lorazepam is shorter acting, w...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/5678/11887_CE(RA1)_F(T)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Background: Currently, benzodiazepines are the preferred
drugs in the management of alcohol withdrawal symptoms.
Chlordiazepoxide and diazepam, the most frequently used
drugs have a long duration of action and are converted to active
metabolites in the liver, while lorazepam is shorter acting, with no
active metabolites.
Objective: To compare and evaluate the safety and efficacy
of lorazepam and chlordiazepoxide in patients with alcohol
dependence syndrome with symptoms of alcohol withdrawal.
Materials and Methods: This was a prospective, randomized,
double-blind, study carried out at a teaching hospital in Bangalore.
Sixty patients aged ≥18 y with alcohol dependence syndrome
with mild-to-moderate withdrawal symptoms were allocated at a
ratio of 1:1 to either lorazepam or chlordiazepoxide, by means of
a computer-generated randomization chart. Thirty patients each
were started with lorazepam tablets 8 mg/day and chlordiazepoxide
80 mg/day. For both treatment groups, the dose was tapered and
at the end of 8 days, the patients were drug-free. The severity of
alcohol dependence was assessed using the Severity of Alcohol
Dependence Questionnaire (SADQ). The CIWA-Ar was used for
quantification of withdrawal symptoms. Liver function tests were
performed at baseline and at the end of the study.
Results: Of the 60 patients included in the study, 15 patients
each had mild and moderate withdrawal symptoms in the
chlordiazepoxide group and 17 and 13 patients respectively in
the lorazepam group, based on the SADQ score. At baseline, the
mean CIWA-Ar scores were similar in both the treatment groups:
24.77±5.98 in the chlordiazepoxide group and 24.90±6.12 in the
lorazepam group. There was a significant intragroup decrease in
the CIWA-Ar scores measured from baseline to the end of 8 days
(p<0.0001) and 12 days (p<0.0001) in both treatment groups;
however, there was no significant difference between the two
groups. There was no significant difference observed in the liver
function tests done at baseline and at the end of study period.
Conclusion: Lorazepam is noninferior to chlordiazepoxide in
reducing alcohol withdrawal symptoms. |
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| ISSN: | 2249-782X 0973-709X |