clomethiazole-edisylate and Alcoholism

A clinical analysis of 476 cases of delirium tremens is presented. The sample covers virtually all cases of delirium tremens that occurred in the Helsingborg Health Service District during the period 1975-1980. A retrospective analysis of the incidence of delirium tremens over the observation period shows that there was an increase in the number and severity of cases developing delirium tremens when non-cross-tolerant drugs, such as carbamazepine and neuroleptics, were used as first-line treatment for acute alcohol withdrawal. The results also show that when chlormethiazole (a drug exhibiting a certain degree of cross-tolerance with ethanol) was used either as the first-line treatment for all cases or as the first-line treatment for predetermined "high risk" patients, the incidence of delirium tremens was greatly reduced. The favourable findings when chlormethiazole treatment was initiated at an early stage in the "high risk" patients suggest that chlormethiazole has a protective action against delirium tremens. Moreover, in the occasional case in which delirium tremens occurred during chlormethiazole treatment, the disorder was milder and relatively easy to treat.

Topics: Alcohol Withdrawal Delirium; Alcoholism; Chlormethiazole; Drug Administration Schedule; Drug Therapy, Combination; Drug Tolerance; Humans; Psychoses, Alcoholic; Retrospective Studies; Sweden

Dopamine (DA) sensitivity, assessed through maximal growth hormone (GH) response to stimulation by apomorphine (APO) (0.18-0.24 mg iv) was studied in 16 chronic alcoholics newly admitted after a period of heavy alcohol intake. Repeated hormonal tests were thereafter performed during a 2-month period under strictly controlled conditions to avoid relapse into alcohol consumption. Eight healthy volunteers with alcohol consumption slightly less than that of the general population were used as controls. It was found that DA sensitivity in the early abstinence phase was higher than later in the 2-month recovery period but not significantly different from control values. The relatively higher DA sensitivity in the early abstinence phase might be responsible for a lower threshold for psychotic symptoms and neuroleptic-induced extrapyramidal side effects. The results of this study give further evidence of a prolonged recovery phase after heavy alcohol intake.

Topics: Adult; Alcoholism; Anti-Anxiety Agents; Anticonvulsants; Apomorphine; Benzodiazepines; Chlormethiazole; Ethanol; Female; Growth Hormone; Humans; Male; Middle Aged; Pituitary Gland, Anterior; Receptors, Dopamine; Substance Withdrawal Syndrome

Topics: Alcoholism; Chlormethiazole; Combined Modality Therapy; Drug Tolerance; Ethanol; Humans; Motivation; Promethazine

Seizures and delirium tremens were recorded among 292 randomly selected patients admitted to an in-patient alcoholism program. Despite the almost routine prophylactic use of anticonvulsant and sedative drugs the incidence of seizures and delirium tremens during detoxification in hospital was 3%. However, as most alcohol withdrawal seizures occurred immediately before admission, the overall seizure incidence was higher (10%). Those patients who developed seizures during detoxification admitted previous abuse of benzodiazepines or erratic use of phenytoin. The results suggest that prescribing of anticonvulsants to alcoholics may increase their seizure problems, because they are prone to erratic drug taking, and because of drug-alcohol interactions, increased drug metabolism and abuse of the sedative anticonvulsants.

Topics: Adult; Aged; Alcohol Withdrawal Delirium; Alcoholism; Anticonvulsants; Carbamazepine; Chlormethiazole; Female; Humans; Male; Middle Aged; Oxazepam; Pentobarbital; Phenytoin; Psychoses, Alcoholic; Seizures; Substance Withdrawal Syndrome

Topics: Alcoholism; Behavior, Addictive; Chlormethiazole; Drug Therapy; Humans; Substance-Related Disorders; Thiazoles

Topics: Alcoholism; Chlormethiazole; Thiazoles