Gabapentin Use in Acute Alcohol Withdrawal Management
Gabapentin’s anxiolytic and sedative properties along with its overall safety profile suggest that it may be a viable adjuvant to lorazepam in the management of acute alcohol withdrawal.
Dr. Wilming is a PGY-1 Pharmacy Practice Resident, Dr. Alford is a General Medicine Clinical Pharmacist, and Dr. Klaus is an Associate Chief of Acute Care Pharmacy and PGY-1 Acute Care Residency Director, all at the VA Portland Health Care System in Oregon. Correspondence: Dr. Wilming (christopher.wilming @va.gov)
Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review the complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.
Conclusion
On average, the required benzodiazepine dosage was lower with concomitant use of gabapentin in acute AWS management. The duration for patients on alcohol withdrawal protocol was not reduced with use of gabapentin. Between group (ie, history of withdrawal seizures, blood alcohol level) and among group (ie, gabapentin administration) differences prevent direct correlations to be drawn from this evaluation. Future reviews should include power analysis to establish an appropriate sample size to determine statistical significance among identified covariates. Further evaluation of the use of gabapentin for withdrawal management is warranted prior to incorporating its routine use in the current standard of care for patients experiencing acute AWS.
Acknowledgments The authors thank Ryan Bickel, PharmD, BCCCP, Critical Care Clinical Pharmacist; Stephen M. Smith, PhD, Director of Medical Critical Care; Gordon Wong, PharmD, Clinical Applications Coordinator; and Eileen Wilbur, RPh, Research Pharmacy Supervisor.
