Alcohol Withdrawal Syndrome: Clinical and Hormonal Responses to alpha2-Adrenergic Agonist Treatment

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Abstract
Lofexidine (L) was compared to placebo (P) in a random double blind placebo controlled study of 23 healthy alcoholics in withdrawal. In serial alcohol withdrawal syndrome (AWS) scales, P > L for first 18 hr. The major changes in AWS were in blood pressure and pulse, while restlessness or diaphoresis did not show faster normalization with L vs. P. Other ratings of withdrawal intensities and craving by patients were similar in both P and L. There were no differences in the rate of patient completion, or appearance of hallucinations by group. Plasma catecholamines were in the high ranges, similar in both groups at 0 and 3 hr, but after 5 hr P > L for norepinephrine (but not epinephrine or dopmaine). The data suggest L has pharmacological effects on some objective, catecholamine related, components of alcohol withdrawal, with little effect on others. L type treatment of alcoholics in withdrawal is promising, modestly effective and warrants further study.