Efficacy of Gabapentin for the Treatment of Alcohol Use Diso
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In this randomized clinical trial, gabapentin compared with placebo significantly increased the number of people with total abstinence and reduced drinking.

This effect was most significantly observed in those with greater pretreatment alcohol withdrawal symptoms- 41% of participants with high alcohol withdrawal symptoms had total abstinence on gabapentin compared with 1% of participants in the placebo arm.

Of 96 randomized individuals, 90 were evaluable (44 in the gabapentin arm and 46 in the placebo arm). The evaluable participants had 83% baseline heavy drinking days (4 or more drinks/day for women, 5 or more for men) and met 4.5 alcohol withdrawal criteria from the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition).

More gabapentin-treated individuals had no heavy drinking days, a difference of 18.6%, and more total abstinence, a difference of 13.8%. 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.

Conclusively, these data, combined with others, suggest gabapentin might be most efficacious in people with AUD and a history of alcohol withdrawal symptoms. Future studies should evaluate sleep changes and mood during early recovery as mediators of gabapentin efficacy.

Source: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2762700