DOI: 10.36347/sjams.2017.v05i10.048

Pages: 4051-4056

Alcohol withdrawal is treated by cross tolerant benzodiazepines like Chlordiazepoxide, Diazepam and Lorazepam. The most frequently used Drugs Diazepam and Chlordiazepoxide have a long duration of action and are converted to active metabolites in the liver, while Lorazepam is metabolized by conjugation, which is less effected than the microsomal liver enzyme pathway in liver disease and it is short acting, with no active metabolites. The objective is to compare the clinical outcome and cost in treating uncomplicated alcohol withdrawal state using Chlordizepoxide and Lorazepam. This is a prospective, randomized, double blind, interventional study. Sixty patients with alcohol dependence syndrome with moderate withdrawal symptoms were allocated to receive either Chlordiazepoxide or Lorazepam, by means of a computer generated random sequence at a ratio of 1:1. Those with moderate to severe dependence on SADQ (20 and above) and moderate withdrawal on CIWA-Ar (10-15) were included in the study Thirty patients each were started with lorazepam tablets 8 mg/day and chlordiazepoxide 100 mg/day. For both treatment groups, the dose was tapered and at the end of 8 days, the patients were drug-free. At baseline, the mean CIWA-Ar scores were similar in both the treatment groups: 12.60±1.380 in the chlordiazepoxide group and 12.70±1.466 in the lorazepam group. There was a significant intragroup decrease in the CIWA-Ar scores measured from baseline to the end of 10days in both treatment groups; however, there was no significant difference between the two groups. There was no significant difference observed between the two groups in the liver function tests done at baseline and at the end of study. The cost of treating moderate alcohol withdrawal with Chlordiazepoxide and Lorazepam was Rs 9.00 and Rs 5.00 per person for the duration of treatment respectively. Lorazepam is as good option as Chlordiazepoxide in reducing alcohol withdrawal symptoms.