The Use of Anticonvulsant Adjuncts to Treat Alcohol Withdrawal Syndrome in Older Adults

Authors

  • Stefanie Montgomery University of British Columbia
  • Karen Dahri Vancouver General Hospital; University of British Columbia
  • Kaveh Rayani University of British Columbia
  • Jacqueline Kwok University of British Columbia
  • Peter Chan University of British Columbia; Vancouver General Hospital

DOI:

https://doi.org/10.5770/cgj.25.544

Keywords:

geriatric, alcohol, withdrawl, benzodiazepines, anticonvulsant, older adult

Abstract

Background 

We evaluated the prescribing practices of anticonvulsant (AC) adjuncts to benzodiazepines in managing Alcohol Withdrawal Syndrome (AWS). We also examined the prescription of relapse prevention agents for Alcohol Use Disorder (AUD), and adverse events related to AWS treatment. 

Methods 

Records were reviewed retrospectively pertaining to medically ill adults aged 60 and above with AWS and admitted to a medicine or hospitalist unit of a Canadian centre between June 2013 and June 2018. Duration and dosing of benzodiazepine, dosing and type of AC and AUD agent, and adverse events were collected. A multivariable regression model was employed. 

Results 

83 encounters were included in the study and 28 were prescribed an AC. The amount and duration of benzodiazepine administered were not statistically different between the benzodiazepine only and the AC adjunct groups, once severe AWS complications were accounted for. Five new prescriptions of traditional AUD agents were provided on discharge. No AC-associated adverse events occurred. 

Conclusions 

AC adjuncts for AWS did not decrease the amount of benzodiazepine administered nor shorten the duration of treatment. Their routine use is not supported by our findings. Our study highlights a missed opportunity for AUD agents to be prescribed during hospitalization. 

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Published

2022-03-02

How to Cite

1.
Montgomery S, Dahri K, Rayani K, Kwok J, Chan P. The Use of Anticonvulsant Adjuncts to Treat Alcohol Withdrawal Syndrome in Older Adults. Can Geriatr J [Internet]. 2022 Mar. 2 [cited 2022 May 16];25(1):32-9. Available from: https://cgjonline.ca/index.php/cgj/article/view/544

Issue

Section

Original Research