It was observed that the use of gabapentin could be effective in people with Alcohol Use Disorder (AD) and a history of withdrawal symptoms. Specifically in the prevention of relapse and after the start of abstinence to maintain it. It may also work better in those with a history of more severe alcohol withdrawal symptoms.
Because it is important? According to the authors, in the United States alone an estimated 30 million people meet the criteria for EDs, but few receive appropriate pharmacotherapy (20%).
On the other hand, data on the effectiveness of gabapentin have been diverse and inconclusive.
Why gabapentin? The scientists write: “Alcohol withdrawal symptoms are thought to be primarily mediated by γ-aminobutyric acid (GABA) and brain glutamate signaling in contrast to reward-based craving, in which brain opioid and dopamine signaling plays a role.” a more important role. Therefore, medications that target the brain GABA and brain glutamate signaling systems may be particularly useful in the treatment of alcohol withdrawal symptoms and, by extension, in those who have previously shown a biological propensity to experience symptoms. of alcohol abstinence.”
What methodology was used? It was a double-blind randomized clinical trial, carried out between November 2014 and June 2018. It sought to evaluate the efficacy of gabapentin vs a placebo.
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Participants included 154 people who met DSM V criteria for EDs and 96 who met criteria for recent alcohol withdrawal symptoms.
Daily alcohol consumption was recorded and the percentage of disial carbohydrate-deficient transferrin in the blood (a marker of excessive alcohol consumption) was collected at baseline and monthly during treatment.
Gabapentin treatment consisted of up to 1200 mg daily, given orally.
What is suggested for the following investigations? Future studies should specifically evaluate symptoms related to prolonged alcohol withdrawal during gabapentin treatment. Since this knowledge would give doctors another alternative when choosing a medication to treat ED and therefore encourage greater patient participation in treatment, with a greater expectation of success.
Study reference: Anton, R., Latham, P., Voronin, K., Book, S., Hoffan, M., Prisciandaro, J. and Bristol, E. (2020), Efficacy of Gabapentin for the Treatment of Alcohol Use Disorder in Patients With Alcohol Withdrawal Symptoms: A Randomized Clinical Trial, DOI: 10.1001/jamainternmed.2020.0249