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Thirty- Versus Ten-Day Diazepam Treatment for Alcohol Detoxification and a Comparison of Drinking Patterns, Craving, and Anxiety for up to 12 Weeks: A “Proof-of-Concept” Open-Label Randomized Controlled Trial

Simioni, Nicolas MD*†‡; Labreuche, Julien MStat§; Behal, Hélène MStat§; Cottencin, Olivier MD, PhD*∥; Rolland, Benjamin MD, PhD

Journal of Clinical Psychopharmacology: December 2017 - Volume 37 - Issue 6 - p 722–728
doi: 10.1097/JCP.0000000000000786
Brief Reports
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Purpose The aim of this study was to evaluate whether a prolonged detoxification treatment could decrease the relapse rate at 3 months after alcohol cessation in alcohol-dependent individuals through decreasing the levels of postdetoxification craving and anxiety.

Methods Twenty-six adult patients with alcohol dependence (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) who began an outpatient alcohol cessation program with an initial drinking goal of abstinence were enrolled in a 3-month, parallel, randomized (1:1 ratio), controlled, open-label, pilot trial. Participants were randomized to receive a detoxification treatment of diazepam with a duration of 30 (n = 12) or 10 days (n = 14). All participants received BRENDA-based psychotherapy during follow-up.

Results No significant between-group difference in relapse to any drinking was found at 3 months (P = 0.20). However, relapse to any heavy drinking at 3 months and regular drinking or heavy drinking during follow-up were significantly lower in the 30-day diazepam group (P = 0.009, P = 0.049, and P = 0.004, respectively). These differences were corroborated by significant differences in the alcohol-specific biological marker carbohydrate deficient transferrin at 3 months. Participants in the 30-day diazepam group also displayed significantly lower scores for alcohol craving (P = 0.007), self-reported anxiety (P = 0.024), and clinician-assessed anxiety (P = 0.002) throughout the follow-up. No serious adverse event was reported during the study.

Conclusion This study provides an evidence-based rationale for a double-blind, randomized, placebo-controlled trial to confirm the efficacy of such a procedure on short-term and mid-/long-term drinking outcomes after alcohol cessation in alcohol-dependent individuals.

From the *Département de Psychiatrie et d'Addictologie, CHU Lille, Lille; †Etablissement Public de Santé Mentale, Val de Lys–Artois, Centre de Soins d'Accompagnement et de Prévention en Addictologie, Béthune, France; ‡The Phenix Foundation, Geneva, Switzerland; and §Santé publique: épidémiologie et qualité des soins, EA 2694, CHU Lille, ∥SCALab-PsyCHIC Team, CNRS UMR 9193, and ¶Département de Pharmacologie, INSERM U1171, University of Lille, Lille, France.

Received November 22, 2016; accepted after revision July 24, 2017.

Reprints: Benjamin Rolland, MD, PhD, Département de Psychiatrie et d'Addictologie, Service d'Addictologie CHU de Lille, 1 rue Verhaeghe, 59037 Lille Cedex, France (e-mail: benjrolland@gmail.com).

This research was funded by La Fédération de Recherche Clinique du CHU de Lille («The Federation of the University Hospital of Lille for Clinical Research»).

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