Atenolol Appears Effective in Alcohol Withdrawal Syndrome And this study supports the drug's use in patients with mild to moderate symptoms

In a double-blind study, 120 patients with the alcohol withdrawal syndrome, but not all with abnormal vital (n = 101) and clinical (n = 65) signs and behavioural features (83) of withdrawal, randomly received atenolol (n = 61) or placebo (n = 59) for up to 9 days. Atenolol was given with standard treatments in the following daily doses: • No drug when the heart rate was < 50 beats/min • 50mg when the heart rate was 50-79 beats/min • 100mg when the heart rate was ~ 80 beats/min.

In the group with abnormal'vital signs, atenolol recipients experienced a significantly greater and more rapid improvement in these signs compared with placebo recipients. The improvement was most marked in the first 3 days and, although it was significant until day 6, then decreased steadily. Patients with abnormal clinical and behavioural features also benefitted from treatment with atenolol (but the improvement in these features was not significant compared with placebo). Further, the active drug significantly reduced the mean length of the hospital stay, the mean dose of oxazepam required and the number of patients requiring oxazepam on each treatment day. However, any prophylactic benefits of atenolol were not demonstrated as results achieved when the drug was given to patients who had normal vital and clinical signs and behavioural features at baseline to prevent withdrawal symptoms were not consistent.

A similar number of adverse effects occurred in the 2 groups and included: eNS (n == 34); cardiovascular (n = 17); gastrointestinal (placebo only, n = 10); and respiratory (n = 4) symptoms. No serious adverse reactions occurred and the authors concluded that, because no patients were seriously ill, •.. the results of this trial are applicable to patients with mild to moderate withdrawal symptoms' and ' .•• indicate that atenolol has a useful role in the therapy of patients with mild to moderate alcohol withdrawal syndrome' [see Viewpoints section, this issue, p2]. Kraus, M.L., Gottlieb, L.D.; Horwitz, R.f. and Anscher, M.: New England Journal of Medicine 313. 905·909 (10 Oct (985)

0156-2703/85/1005-0009/0$01.00/0 @ ADIS Press INPHARMA® 16 Nov 1985 9