Results of this review do not provide sufficient evidence in favour of anticonvulsants for the treatment of AWS. There are some suggestions that carbamazepine may actually be more effective in treating some aspects of alcohol withdrawal when compared to benzodiazepines, the current first-line regimen for alcohol withdrawal syndrome. Anticonvulsants seem to have limited side effects, although adverse effects are not rigorously reported in the analysed trials.
Is clonidine useful in the treatment of alcohol withdrawal?
The comparative efficacy of clonidine and chlormethiazole has been examined in the management of acute alcohol withdrawal. A double blind randomized study was conducted in consecutive patients admitted to a hospital detoxification unit. Patients were assessed regularly by a standard alcohol withdrawal rating-scale. Thirty-two patients received either clonidine or chlormethiazole in reducing dosages over 96 hr. All the patients receiving chlormethiazole had uneventful withdrawals. However, eight patients treated with clonidine were withdrawn from the trial due to hallucinations (two), seizures (two), symptomatic orthostatic hypotension (three) or drowsiness (one), indicating that clonidine is less effective than chlormethiazole in the prevention of the major manifestations of alcohol withdrawal.