Tags

Type your tag names separated by a space and hit enter

Self-reported sleep, sleepiness, and repeated alcohol withdrawals: a randomized, double blind, controlled comparison of lorazepam vs gabapentin.
J Clin Sleep Med. 2007 Feb 15; 3(1):24-32.JC

Abstract

STUDY OBJECTIVES

Insomnia is a central symptom of alcohol withdrawal and increases relapse potential. The primary objective of this study was to compare the efficacy of gabapentin to lorazepam in alleviating sleep disturbances and daytime sleepiness during an episode of alcohol withdrawal. The secondary objective of this study was to determine if drug treatment efficacy differed by the patient history of previous treatments for alcohol withdrawal.

METHODS

Outpatients in treatment for alcohol withdrawal received a 4-day fixed-dose taper of gabapentin or lorazepam in a double-blind, randomized, controlled trial with an 8-day follow-up. Daily across a 5 day outpatient treatment and Days 7 and 12 post-treatment, patients self-reported daytime sleepiness using the Epworth Sleepiness Scale. Self-reports of depression (Beck Depression Inventory) were completed at Days 1, 5, 7 and 12. Staff assessed daily alcohol withdrawal using the Clinical Institute Withdrawal Assessment for Alcohol. From these instruments, self-reported sleep and sleepiness were extracted and assessed in the context of limited (0-1) or multiple (2 or more) previously treated alcohol withdrawal episodes.

RESULTS

Patients with limited previous withdrawals reported similar treatment effects on self-reports of sleep and sleepiness for gabapentin and lorazepam. In contrast, patients with multiple previous alcohol withdrawals receiving gabapentin reported reduced sleep disturbances and sleepiness in comparison to those receiving lorazepam.

CONCLUSIONS

During treatment for alcohol withdrawal, gabapentin as compared to standard therapy with lorazepam, was superior on multiple sleep measures, in patients who had previous withdrawals. Lorazepam subjects experienced rebound symptoms. Early drinking was related to persisting insomnia with both drugs.

Authors+Show Affiliations

Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, USA. malcolmr@musc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17557449

Citation

Malcolm, Robert, et al. "Self-reported Sleep, Sleepiness, and Repeated Alcohol Withdrawals: a Randomized, Double Blind, Controlled Comparison of Lorazepam Vs Gabapentin." Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, vol. 3, no. 1, 2007, pp. 24-32.
Malcolm R, Myrick LH, Veatch LM, et al. Self-reported sleep, sleepiness, and repeated alcohol withdrawals: a randomized, double blind, controlled comparison of lorazepam vs gabapentin. J Clin Sleep Med. 2007;3(1):24-32.
Malcolm, R., Myrick, L. H., Veatch, L. M., Boyle, E., & Randall, P. K. (2007). Self-reported sleep, sleepiness, and repeated alcohol withdrawals: a randomized, double blind, controlled comparison of lorazepam vs gabapentin. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, 3(1), 24-32.
Malcolm R, et al. Self-reported Sleep, Sleepiness, and Repeated Alcohol Withdrawals: a Randomized, Double Blind, Controlled Comparison of Lorazepam Vs Gabapentin. J Clin Sleep Med. 2007 Feb 15;3(1):24-32. PubMed PMID: 17557449.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Self-reported sleep, sleepiness, and repeated alcohol withdrawals: a randomized, double blind, controlled comparison of lorazepam vs gabapentin. AU - Malcolm,Robert, AU - Myrick,L Hugh, AU - Veatch,Lynn M, AU - Boyle,Elizabeth, AU - Randall,Patrick K, PY - 2007/6/15/pubmed PY - 2007/7/25/medline PY - 2007/6/15/entrez SP - 24 EP - 32 JF - Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine JO - J Clin Sleep Med VL - 3 IS - 1 N2 - STUDY OBJECTIVES: Insomnia is a central symptom of alcohol withdrawal and increases relapse potential. The primary objective of this study was to compare the efficacy of gabapentin to lorazepam in alleviating sleep disturbances and daytime sleepiness during an episode of alcohol withdrawal. The secondary objective of this study was to determine if drug treatment efficacy differed by the patient history of previous treatments for alcohol withdrawal. METHODS: Outpatients in treatment for alcohol withdrawal received a 4-day fixed-dose taper of gabapentin or lorazepam in a double-blind, randomized, controlled trial with an 8-day follow-up. Daily across a 5 day outpatient treatment and Days 7 and 12 post-treatment, patients self-reported daytime sleepiness using the Epworth Sleepiness Scale. Self-reports of depression (Beck Depression Inventory) were completed at Days 1, 5, 7 and 12. Staff assessed daily alcohol withdrawal using the Clinical Institute Withdrawal Assessment for Alcohol. From these instruments, self-reported sleep and sleepiness were extracted and assessed in the context of limited (0-1) or multiple (2 or more) previously treated alcohol withdrawal episodes. RESULTS: Patients with limited previous withdrawals reported similar treatment effects on self-reports of sleep and sleepiness for gabapentin and lorazepam. In contrast, patients with multiple previous alcohol withdrawals receiving gabapentin reported reduced sleep disturbances and sleepiness in comparison to those receiving lorazepam. CONCLUSIONS: During treatment for alcohol withdrawal, gabapentin as compared to standard therapy with lorazepam, was superior on multiple sleep measures, in patients who had previous withdrawals. Lorazepam subjects experienced rebound symptoms. Early drinking was related to persisting insomnia with both drugs. SN - 1550-9389 UR - https://www.unboundmedicine.com/medline/citation/17557449/Self_reported_sleep_sleepiness_and_repeated_alcohol_withdrawals:_a_randomized_double_blind_controlled_comparison_of_lorazepam_vs_gabapentin_ L2 - https://medlineplus.gov/alcoholusedisorderaud.html DB - PRIME DP - Unbound Medicine ER -