6/29/23, 11:57 PM Symptom-triggered vs. fixed-dose benzodiazepines for alcohol withdrawal Pathway Feedback Search Clinical Topics Home Studies Symptom-triggered vs. fixed-dose benzodiazepines for alcohol withdrawal Symptom-triggered vs. fixed-dose benzodiazepines for alcohol withdrawal Disease Alcohol use disorder Trial question Is symptom-triggered doses of benzodiazepine superior to fixed-schedule doses of benzodiazepine in patients with alcohol withdrawal? Study design Multi-center Double blinded RCT Population Characteristics of study participants 23.0% female N = 117 77.0% male 117 patients (27 female, 90 male) Inclusion criteria: patients with alcohol dependence entering an alcohol treatment program Key exclusion criteria: last alcoholic beverage intake > 72 hours prior to admission; daily use of medication for treatment of alcohol withdrawal for the 30 days prior to admission (ie, benzodiazepines, barbiturates, or clomethiazole); major cognitive, psychiatric, or medical comorbidity; opiate or stimulant dependence; and/or no fluency in French Interventions N=56 symptom-triggered benzodiazepine administration (oxazepam in response to the development of signs of alcohol withdrawal) https://web.pathway.md/studies/recfKpFpUS7ACpKIW 1/2 6/29/23, 11:57 PM Symptom-triggered vs. fixed-dose benzodiazepines for alcohol withdrawal Pathway N=61 fixed-schedule benzodiazepine administration (oxazepam every 6 hours with additional doses as needed) Primary outcome Total amount of oxazepam administered 231.4 mg 231.4 173.6 mg 115.7 mg 57.9 mg Significant decrease 37.5 0.0 mg Symptom-triggered benzodiazepine administration Fixed-schedule benzodiazepine administration Significant decrease in total amount of oxazepam administered (37.5 mg vs. 231.4 mg; ARD -193.9, 95% CI -308.95 to -78.85) Secondary outcomes Significant decrease in duration of treatment with oxazepam (20 hours vs. 62.7 hours; MD -42.7, 95% CI -68.04 to -17.36) Safety outcomes Significant difference in seizures (1 vs. 0). Conclusion In patients with alcohol dependence entering an alcohol treatment program, symptom-triggered benzodiazepine administration was superior to fixed-schedule benzodiazepine administration with respect to total amount of oxazepam administered. Reference Daeppen JB, Gache P, Landry U et al. Symptom-triggered vs fixed-schedule doses of benzodiazepine for alcohol withdrawal: a randomized treatment trial. Arch Intern Med. 2002 May 27;162(10):1117-21. Open reference URL https://web.pathway.md/studies/recfKpFpUS7ACpKIW 2/2