Gabapentin and ETOH disorder

Q: 57 years old male with history of active alcoholism is admitted to the ICU after Motor Vehicle Accident (MVA), requiring orthopedic surgery. The on-call resident wanted to initiate the Enhanced Recovery After Surgery (ERAS) protocol, which includes the use of Gabapentin. It is not a good idea to prescribe Gabapentin to a patient with a history of alcohol abuse.

A) True

B) False

Answer: B

Gabapentin is considered one of the second-line drugs for patients with alcohol abuse. It has been shown to decrease the heavy drinking days. The beneficial effect of Gabapentin gets even more pronounced in withdrawal symptoms, like patient in this question who is at high risk of Delirium Tremens (DT) while recovering in the ICU.

Another such drug described with beneficial effects is Baclofen.

#toxicity

#ETOH-abuse

#pharmacology

References:

1. Mason BJ, Quello S, Goodell V, et al. Gabapentin treatment for alcohol dependence: a randomized clinical trial. JAMA Intern Med 2014; 174:70.

2. Anton RF, Latham P, Voronin K, et al. Efficacy of Gabapentin for the Treatment of Alcohol Use Disorder in Patients With Alcohol Withdrawal Symptoms: A Randomized Clinical Trial. JAMA Intern Med 2020; 180:728.

3. Gratacós-Ginès J, Bruguera P, Pérez-Guasch M, et al. Medications for alcohol use disorder promote abstinence in alcohol-associated cirrhosis: Results from a systematic review and meta-analysis. Hepatology 2024; 79:368.

4. Rose AK, Jones A. Baclofen: its effectiveness in reducing harmful drinking, craving, and negative mood. A meta-analysis. Addiction 2018; 113:1396.