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Treatment of alcohol withdrawal syndrome with a combination of tiapride/carbamazepine

Results of a pooled analysis in 540 patients

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Abstract

This was a retrospective study to examine the efficacy, practicability and medical safety of a combination of tiapride and unretarded (fast acting formula) carbamazepine in the treatment of alcohol withdrawal syndrome. In five hospitals using this combination for treatment of alcohol withdrawal, 540 patients who had been treated with this combination were identified. An intensive evaluation of patients files and charts was performed. Details of alcohol history and comorbid disorders were extracted from patient files. Severity of alcohol withdrawal had been assessed using the CIWA-A-Score. Gender differences and differences between patients in their first and at least second withdrawal were computed by means of variance analyses (GLM). At baseline (day 1) mean dosage given was 796 for tiapride and 543 mg for carbamazepine. A pooled analysis of the results showed that, in general, medication was well tolerated. Withdrawal symptomatology as indicated by CIWA-A scores clearly decreased over time. Although a significant number of patients had a history of alcohol withdrawal delirium (103) and epileptic seizures (151), few patients suffered from them during treatment (8 and 5, respectively). Only 24 (4.4%) patients dropped out because of lack of efficacy or change of medication, 15 (2.8%) because of side effects. No case of malignant neuroleptic syndrome was recorded. Data analysis showed gender differences and differences between patients in their first and at least second withdrawal for side effects, complications, and in some CIWA-A-scores. In general, severe complications of withdrawal syndrome were more frequent in men compared to women and in patients with repeated inpatient treatment. In line with previous research, the results from this study give further evidence that a combination of the anticonvulsant carbamazepine and tiapride is an effective and safe treatment for alcohol withdrawal treatment.

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Acknowledgement

This study was supported by an unrestricted educational grant by the pharmaceutical company Sanofi-Aventis.

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Authors and Affiliations

  1. Psychiatric Hospital, University of Munich, Nussbaumstr. 7, 80336, München, Germany

    Michael Soyka MD & Peggy Schmidt PhD

  2. Psychiatric Hospital, University of Giessen, Am Steg 22, 35385, Giessen, Germany

    Michael Franz MD

  3. Psychiatric Hospital, Klinikum Chemnitz, Dresdner Str. 178, 09131, Chemnitz, Germany

    Thomas Barth MD & Michael de Groot MD

  4. Psychiatric University Clinic, Charité in St Hedwig Hospital, Turmstr. 21, 10559, Berlin, Germany

    Thorsten Kienast MD & Christoph Richter MD

  5. Psychiatric Hospital, Krankenhausstr. 17, 42555, Velbert, Germany

    Thomas Reinert MD

  6. Psychiatric Hospital, Rud-Wahrendorff-Str. 22, 31319, Sehnde, Germany

    Greif Sander MD

  7. Private Hospital Meiringen, P.O. Box 612, 3860, Meiringen, Switzerland

    Michael Soyka MD

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  1. Michael Soyka MD
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Soyka, M., Schmidt, P., Franz, M. et al. Treatment of alcohol withdrawal syndrome with a combination of tiapride/carbamazepine. Eur Arch Psychiatry Clin Neurosci 256, 395–401 (2006). https://doi.org/10.1007/s00406-006-0644-8

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  • DOI: https://doi.org/10.1007/s00406-006-0644-8

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