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Prevention of alcohol withdrawal seizures with carbamazepine and valproic acid
Abstract
To evaluate the value of the nonsedative anticonvulsants carbamazepine and valproic acid a controlled study including drug monitoring was carried out. Intoxicated alcoholics (n = 138) were admitted for inpatient detoxication and randomly assigned to either carbamazepine (n = 43), sodium valproate (n = 46) or placebo (n = 49) in a double-blind fashion. Drug treatment lasted for four days and the daily doses of both drugs amounted to 1200 mg in the beginning of the study. Sodium valproate induced gastric distress, nausea and vomiting more frequently than placebo. About half of the subjects had to stop carbamazepine because of intolerable side-effects including vertigo, nausea, vomiting, diplopia and rash. Serum carbamazepine levels (18-89 mumol/l) were found to be high (greater than 40 mumol/l) in many but not all of these subjects. Seizures occurred in 3 subjects on placebo, 2 on carbamazepine and 1 on sodium valproate. Delirium tremens developed in 2 on sodium valproate and 1 on placebo. The study demonstrates that drug side-effects may seriously hamper the utility of carbamazepine and sodium valproate as routine treatment for the prevention of alcohol withdrawal symptoms.
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Studies from the 1980s identified potential merit of valproate, particularly in ambulatory detox settings, but concluded that adverse effects may outweigh the benefits.
“Studies from the 1980s have identified the potential merit of using valproate, particularly in ambulatory detox settings. However, these studies also concluded that the adverse effects associated with valproate use may outweigh the benefits [32,33].”
From A Narrative Review of Current and Emerging Trends in the Treatment of Alcohol Use Disorder (2024) · cites this paper as [33]
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References 10 · Cited by 81
Research works printed but not linked: 1
- Bonfiglio, 1977, Sodium dipropylacetate as a new hospital drug for the prevention and treatment of alcoholic delirium tremens, Minerva Med., 68, 4233
Metadata
- Authors
- Hillbom, M., Tokola, R., Kuusela, V., Kärkkäinen, P., Källi-Lemma, L., Pilke, A., & Kaste, M.
- Affiliations
- University of Helsinki (FI)
- Corresponding author
- Hillbom, Matti
- ORCID
- Kaste, Markku
- Venue
- Alcohol
- Publisher
- Elsevier BV
- Published
- 1989-05
- Volume
- 6
- Issue
- 3
- Pages
- 223-226
- ISSN
- 0741-8329 (ISSN-L)
- OpenAlex
- W2080372328
- Cited by
- 81
- References
- 10
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2021: 2 · 2019: 1 · 2018: 2 · 2017: 1 · 2015: 4 · 2014: 1 · 2013: 1 · 2012: 3
- FWCI
- 0.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alcohol (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Alcoholism and Thiamine Deficiency
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Clinical Neurology › Epilepsy research and treatment
- Keywords
- alcohol withdrawal seizures, carbamazepine, valproic acid, alcohol detoxification, delirium tremens, anticonvulsant adverse effects, drug monitoring, drug intolerance
- MeSH terms
- Adult, Alcohol Withdrawal Delirium, Ethanol, Carbamazepine, Female, Humans, Male, Middle Aged, Seizures, Substance Withdrawal Syndrome, Valproic Acid
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