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A randomized double-blind pilot trial of gabapentin versus placebo to treat alcohol dependence and comorbid insomnia.
Alcohol Clin Exp Res. 2008 Aug; 32(8):1429-38.AC

Abstract

BACKGROUND

Insomnia and other sleep disturbances are common, persistent, and associated with relapse in alcohol-dependent patients. The purpose of this pilot study was to compare gabapentin versus placebo for the treatment of insomnia and prevention of relapse in alcohol-dependent patients.

METHODS

Twenty-one subjects, including 10 women who met study criteria for alcohol dependence and insomnia and expressed a desire to abstain from alcohol, were recruited to the study. During a 1 to 2 week placebo lead-in and screening phase, a complete medical history, physical exam, blood tests, urine drug test, and structured interviews were performed to determine eligibility and patterns of alcohol use and sleep. Insomnia due to intoxication or acute withdrawal, psychiatric or medical illness, medications, and other sleep disorders were ruled out. Subjects were then randomized to either placebo (n = 11) or gabapentin (n = 10) for 6 weeks and titrated over a 10-day period to 1,500 mg or 5 pills at bedtime. After a 4-day taper, subjects were reassessed 6 weeks after ending treatment.

RESULTS

Gabapentin significantly delayed the onset to heavy drinking, an effect which persisted for 6 weeks after treatment ended. Insomnia improved in both treatment groups during the medication phase, but gabapentin had no differential effects on sleep as measured by either subjective report or polysomnography.

CONCLUSION

Because gabapentin is a short-acting medication that was taken only at nighttime in this study, it may possibly exert a nocturnal effect that prevents relapse to heavy drinking by a physiological mechanism not measured in this pilot study.

Authors+Show Affiliations

University of Michigan Addiction Research Center, 4250 Plymouth Road, Ann Arbor, MI 48109-5740, USA. kbrower@umich.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18540923

Citation

Brower, Kirk J., et al. "A Randomized Double-blind Pilot Trial of Gabapentin Versus Placebo to Treat Alcohol Dependence and Comorbid Insomnia." Alcoholism, Clinical and Experimental Research, vol. 32, no. 8, 2008, pp. 1429-38.
Brower KJ, Myra Kim H, Strobbe S, et al. A randomized double-blind pilot trial of gabapentin versus placebo to treat alcohol dependence and comorbid insomnia. Alcohol Clin Exp Res. 2008;32(8):1429-38.
Brower, K. J., Myra Kim, H., Strobbe, S., Karam-Hage, M. A., Consens, F., & Zucker, R. A. (2008). A randomized double-blind pilot trial of gabapentin versus placebo to treat alcohol dependence and comorbid insomnia. Alcoholism, Clinical and Experimental Research, 32(8), 1429-38. https://doi.org/10.1111/j.1530-0277.2008.00706.x
Brower KJ, et al. A Randomized Double-blind Pilot Trial of Gabapentin Versus Placebo to Treat Alcohol Dependence and Comorbid Insomnia. Alcohol Clin Exp Res. 2008;32(8):1429-38. PubMed PMID: 18540923.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized double-blind pilot trial of gabapentin versus placebo to treat alcohol dependence and comorbid insomnia. AU - Brower,Kirk J, AU - Myra Kim,Hyungjin, AU - Strobbe,Stephen, AU - Karam-Hage,Maher A, AU - Consens,Flavia, AU - Zucker,Robert A, Y1 - 2008/06/06/ PY - 2008/6/11/pubmed PY - 2009/1/23/medline PY - 2008/6/11/entrez SP - 1429 EP - 38 JF - Alcoholism, clinical and experimental research JO - Alcohol Clin Exp Res VL - 32 IS - 8 N2 - BACKGROUND: Insomnia and other sleep disturbances are common, persistent, and associated with relapse in alcohol-dependent patients. The purpose of this pilot study was to compare gabapentin versus placebo for the treatment of insomnia and prevention of relapse in alcohol-dependent patients. METHODS: Twenty-one subjects, including 10 women who met study criteria for alcohol dependence and insomnia and expressed a desire to abstain from alcohol, were recruited to the study. During a 1 to 2 week placebo lead-in and screening phase, a complete medical history, physical exam, blood tests, urine drug test, and structured interviews were performed to determine eligibility and patterns of alcohol use and sleep. Insomnia due to intoxication or acute withdrawal, psychiatric or medical illness, medications, and other sleep disorders were ruled out. Subjects were then randomized to either placebo (n = 11) or gabapentin (n = 10) for 6 weeks and titrated over a 10-day period to 1,500 mg or 5 pills at bedtime. After a 4-day taper, subjects were reassessed 6 weeks after ending treatment. RESULTS: Gabapentin significantly delayed the onset to heavy drinking, an effect which persisted for 6 weeks after treatment ended. Insomnia improved in both treatment groups during the medication phase, but gabapentin had no differential effects on sleep as measured by either subjective report or polysomnography. CONCLUSION: Because gabapentin is a short-acting medication that was taken only at nighttime in this study, it may possibly exert a nocturnal effect that prevents relapse to heavy drinking by a physiological mechanism not measured in this pilot study. SN - 1530-0277 UR - https://www.unboundmedicine.com/medline/citation/18540923/A_randomized_double_blind_pilot_trial_of_gabapentin_versus_placebo_to_treat_alcohol_dependence_and_comorbid_insomnia_ L2 - https://doi.org/10.1111/j.1530-0277.2008.00706.x DB - PRIME DP - Unbound Medicine ER -