Transdermal clonidine in alcohol withdrawal - Tips From Other Journals

Date: August, 1991

Between 5 and 10 percent of patients undergoing alcohol withdrawal require treatment with a psychotropic agent for control of symptoms. Traditionally, the benzodiazepines have been considered the drugs of choice, despite their potential for addiction and abuse. Clonidine, because of its central sympatholytic properties, is an appropriate alternative to the benzodiazepines and has virtually no potential for abuse. Baumgartner and Rowen conducted a prospective, double-blind study to compare the efficacy of transdermal clonidine with that of chlordiazepoxide in alleviating the symptoms of acute alcohol withdrawal.

Fifty men who met the criteria for alcohol dependence and who were hospitalized for treatment of severe withdrawal symptoms were included in the study. Patients reported drinking more than 160 g of ethanol daily for at least 10 days prior to the study and more than 80 g of ethanol daily for the previous two years.

Patients were randomly assigned to receive either transdermal clonidine or chlordiazepoxide in a fixed dosage regimen for four days. The chlordiazepoxide group received active oral medication and a placebo patch; the clonidine group received placebo oral medication and an active transdermal patch.

Physical and mental well-being were assessed daily using a variety of measures, principally the Alcohol Withdrawal Assessment Scale. Cognitive function was comparable in both treatment groups, but patients in the clonidine group had a better global response and less anxiety. Clonidine also appeared to be more effective in lowering heart rate and blood pressure. Patients in the clonidine group reported less diarrhea, dizziness, headache and fatigue; patients in the chlordiazepoxide group reported less nausea and vomiting. The authors conclude that transdermal clonidine is an effective treatment for alcohol withdrawal and offers significant advantages over benzodiazepines. (Southern Medical Journal, March 1991, vol. 84, p. 312.)

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