Gabapentin shows promise for treating early alcohol withdrawal symptoms

Abstract

Treating alcohol use disorder (AUD) with gabapentin in the early stages of alcohol withdrawal shows promise, according to a randomized clinical trial reported in JAMA Internal Medicine. The study, “Efficacy of Gabapentin for the Treatment of Alcohol Use Disorder in Patients With Alcohol Withdrawal Symptoms: A Randomized Clinical Trial,” by Raymond F. Anton, M.D., and colleagues, evaluated gabapentin versus placebo in 145 treatment‐seeking people who met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for AUD, 96 of whom were in recent alcohol withdrawal and randomized to treatment after three abstinent days. Daily drinking was recorded, and a heavy drinking blood marker was collected at baseline and monthly. The percentage of individuals with total abstinence and those with no heavy drinking days were compared between treatment groups. The participants had 83% heavy drinking days (four drinks a day for women, five for men) at baseline. More gabapentin‐treated individuals had no heavy drinking days (12 of 44 participants [27%]) compared with placebo (four of 46 participants [9%]), and more total abstinence (eight of 44 [18%]) compared with placebo (two of 46 [4%]). The prestudy high‐alcohol‐withdrawal group had positive gabapentin effects on no heavy drinking days and total abstinence compared with placebo, while within the low‐alcohol‐withdrawal group, there were no significant differences. These findings were similar for other drinking variables, where gabapentin was more efficacious than placebo in the high‐alcohol‐withdrawal group only. Gabapentin caused more dizziness, but this did not affect efficacy.