Whilst internationally benzodiazepines are first choice for treatment of alcohol withdrawal syndrome, Germany has a long tradition with clomethiazole. This study explores effectiveness of clomethiazole versus oxazepam in the treatment of alcohol withdrawal syndrome within an observational, stratified, non-inferiority study in routine care. Main outcome criterion was severity of the alcohol withdrawal syndrome (Alcohol Withdrawal Syndrome [AWS]) Scale in the first five days. Additionally, the association between the detoxification protocol (five vs. ten days) and AWS-Score was examined. 453 patients (74.2 % male, average age 47.1 years [± 9.2]) took part; 249 received oxazepam (55.0 %) and 204 clomethiazole (45.0 %). The average duration of inpatient treatment was 14.0 days (± 6.3) in both groups. The average AWS-score was lower in the oxazepam group compared to the clomethiazole group (50.0 [± 26.5] vs. 56.2 [± 31.5]; p < .05; effect size d = - .25). Patients with a shorter detoxification protocol had a lower AWS sum score compared to patients with a longer protocol (p < .001; d = - .46). In treatment of alcohol withdrawal syndrome in routine care oxazepam yields at least comparable results to clomethiazole.
Clomethiazol und Oxazepam in der stationären Alkoholentzugsbehandlung werden miteinander verglichen. Es handelt sich um eine naturalistische, stratifizierte Nichtunterlegenheitsstudie. Zielkriterium ist die Entzugssymptomatik (AWS) der ersten fünf Tage. 453 Patienten nahmen teil, die mittlere Behandlungsdauer betrug 14,0 (± 6,3) Tage. Der durchschnittliche AWS-Wert der Oxazepamgruppe betrug 50,0 (± 26,5), der der Clomethiazolgruppe 56,2 (± 31,5) Punkte (p < 0,05; d = – 0,25). Oxazepam ist unter Routineversorgungsbedingungen bei der Behandlung der Entzugssymptomatik dem in Deutschland lange Zeit (vorrangig) verwendeten Clomethiazol mindestens gleichwertig.
© Georg Thieme Verlag KG Stuttgart · New York.