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Alcohol and Alcoholism Vol. 36, No. 5, pp. 426-430, 2001
© 2001 Medical Council on Alcohol

A DOUBLE-BLIND RANDOMIZED PLACEBO-CONTROLLED TRIAL OF LOFEXIDINE IN ALCOHOL WITHDRAWAL: LOFEXIDINE IS NOT A USEFUL ADJUNCT TO CHLORDIAZEPOXIDE

Francis Keaney,*, John Strang, Michael Gossop, E. Jane Marshall, Michael Farrell, Sarah Welch, Britta Hahn and Alejandro Gonzalez

National Addiction Centre (Institute of Psychiatry, King's College London and The Maudsley Hospital), 4 Windsor Walk, London SE5 8AF, UK

Received 18 August 2000; in revised form 5 March 2001; accepted 19 April 2001

— Lofexidine is an alpha-adrenoceptor agonist which has proved useful in opiate withdrawal and which, through its attenuation of noradrenergic activity, might be a valuable adjunct in the management of alcohol withdrawal. The objective of this study was to compare the clinical effectiveness and patient retention with adjunctive lofexidine versus placebo in the treatment of alcohol withdrawal under chlordiazepoxide cover. This was done in a prospective double-blind randomized placebo-controlled trial with 72 alcohol-dependent adults referred and admitted for in-patient alcohol detoxification. The adjunctive lofexidine group experienced significantly more severe withdrawal symptoms, greater hypotensive problems, more adverse effects, and no better rates of retention in treatment. Lofexidine provides no discernible benefit as an adjunctive medication (to chlordiazepoxide) in alcohol detoxification and, on the basis of our study, appears to be contra-indicated.


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