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Prevention of alcohol withdrawal seizures with carbamazepine and valproic acid

1989; Elsevier BV; Volume: 6; Issue: 3 Linguagem: Inglês

10.1016/0741-8329(89)90022-0

1873-6823

Matti Hillbom, Riitta Tokola, Viljo Kuusela, Päivi Kärkkäinen, Liisa Källi-Lemma, A. Pilke, Markku Kaste,

Neurological and metabolic disorders

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 μmol/l) were found to be high (>40 μmol/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.