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

Eur Arch Psychiatry Clin Neurosci. 2024 Jun 8. doi: 10.1007/s00406-024-01835-7. Online ahead of print.

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.

Keywords: Alcohol detoxification; Alcohol withdrawal treatment; Carbohydrate-deficient transferrin; Clomethiazole; Diazepam; Dityrosine; Ethyl glucuronide; Inflammation; Malondialdehyde; Phosphatidylethanol; Transaminases.