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Open Access 08-06-2024 | Short Communication

Naturalistic comparison of clomethiazole and Diazepam treatment in alcohol withdrawal: effects on oxidative stress, inflammatory cytokines and hepatic biomarkers

Authors: David Strischewski, Amira Kalmar, Paul C. Guest, Henrik Dobrowolny, Gabriela Meyer-Lotz, Conrad J. Schiffner, Wolfgang Jordan, Ulf J. Müller, Katrin Borucki, Michael Böttcher, Borna Relja, Johann Steiner

Published in: European Archives of Psychiatry and Clinical Neuroscience

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Abstract

Ethanol is metabolized by alcohol dehydrogenase to acetaldehyde and induces cytochrome P450 2E1 (CYP2E1), which generates reactive oxygen species that cause inflammatory liver damage. Clomethiazole, a drug approved for alcohol withdrawal treatment (AWT) in some European countries, inhibits CYP2E1. We hypothesized that clomethiazole would lead to a faster reduction in oxidative stress, inflammatory cytokines, and liver enzymes compared to diazepam treatment. We analysed respective biomarkers in 50 patients undergoing AWT and 25 healthy individuals but found no statistical difference between the two medication groups over 3–5 days. Hence, our hypothesis was not confirmed during this observation period.
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Footnotes
1
According to the manufacturer Cheplapharm, clomethiazole is also approved for AWT in Cyprus, the Czech Republic, Hungary, Iceland, Norway, Poland, Slovenia, Spain, Sweden, Switzerland and the United Kingdom.
 
2
Out of 129 patients who consented to participate, 51 were excluded according to the above exclusion criteria after reviewing medical histories, results of physical examinations and blood tests. This gave a final study population of 78 patients, divided into CMZ (n = 26) and DIAZ (n = 37) treatment groups, and individuals with alcohol dependence who did not require medication during detoxification (n = 15). For this study, the two treatment groups were reduced further to 25 patients each to allow matching for sex, body mass index (BMI), age, smoking, chronic obstructive pulmonary disease (COPD) and age at first AWT.
 
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Metadata
Title
Naturalistic comparison of clomethiazole and Diazepam treatment in alcohol withdrawal: effects on oxidative stress, inflammatory cytokines and hepatic biomarkers
Authors
David Strischewski
Amira Kalmar
Paul C. Guest
Henrik Dobrowolny
Gabriela Meyer-Lotz
Conrad J. Schiffner
Wolfgang Jordan
Ulf J. Müller
Katrin Borucki
Michael Böttcher
Borna Relja
Johann Steiner
Publication date
08-06-2024
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Psychiatry and Clinical Neuroscience
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-024-01835-7