OBJECTIVE: The aim of this study was to compare phenobarbital (PB) versus lorazepam (LZ) in the treatment of alcohol withdrawal in the emergency department (ED) and at 48 hours. METHODS: Prospectively, randomized, consenting patients were assessed using a modified Clinical Institute Withdrawal Assessment (CIWA) score and given intravenous PB (mean, 509 mg) or LZ (mean, 4.2 mg). At discharge, LZ patients received chlordiazepoxide (Librium), and PB patients received placebo. RESULTS:Of 44 patients, 25 received PB, and 19 LZ. Both PB and LZ reduced CIWA scores from baseline to discharge (15.0-5.4 and 16.8-4.2, P < .0001). There were no differences between PB and LZ in baseline CIWA scores (P = .3), discharge scores (P = .4), ED length of stay (267 versus 256 minutes, P = .8), admissions (12% versus 16%, P = .8), or 48-hour follow-up CIWA scores (5.8 versus 7.2, P = .6). CONCLUSION:Phenobarbital and LZ were similarly effective in the treatment of mild/moderate alcohol withdrawal in the ED and at 48 hours.
RCT Entities:
OBJECTIVE: The aim of this study was to compare phenobarbital (PB) versus lorazepam (LZ) in the treatment of alcohol withdrawal in the emergency department (ED) and at 48 hours. METHODS: Prospectively, randomized, consenting patients were assessed using a modified Clinical Institute Withdrawal Assessment (CIWA) score and given intravenous PB (mean, 509 mg) or LZ (mean, 4.2 mg). At discharge, LZpatients received chlordiazepoxide (Librium), and PBpatients received placebo. RESULTS: Of 44 patients, 25 received PB, and 19 LZ. Both PB and LZ reduced CIWA scores from baseline to discharge (15.0-5.4 and 16.8-4.2, P < .0001). There were no differences between PB and LZ in baseline CIWA scores (P = .3), discharge scores (P = .4), ED length of stay (267 versus 256 minutes, P = .8), admissions (12% versus 16%, P = .8), or 48-hour follow-up CIWA scores (5.8 versus 7.2, P = .6). CONCLUSION:Phenobarbital and LZ were similarly effective in the treatment of mild/moderate alcohol withdrawal in the ED and at 48 hours.
Authors: Fadi Hawa; Linsey Gilbert; Benjamin Gilbert; Vanessa Hereford; Aya Hawa; Alsadiq Al Hillan; Mark Weiner; Jeremy Albright; Caleb Scheidel; Ola Al-Sous Journal: Cureus Date: 2021-02-11
Authors: Kathryn F Hawk; Rachel L Glick; Arthur R Jey; Sydney Gaylor; Jamie Doucet; Michael P Wilson; John S Rozel Journal: West J Emerg Med Date: 2019-02-19
Authors: Tessa L Steel; Majid Afshar; Scott Edwards; Sarah E Jolley; Christine Timko; Brendan J Clark; Ivor S Douglas; Amy L Dzierba; Hayley B Gershengorn; Nicholas W Gilpin; Dwayne W Godwin; Catherine L Hough; José R Maldonado; Anuj B Mehta; Lewis S Nelson; Mayur B Patel; Darius A Rastegar; Joanna L Stollings; Boris Tabakoff; Judith A Tate; Adrian Wong; Ellen L Burnham Journal: Am J Respir Crit Care Med Date: 2021-10-01 Impact factor: 21.405