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Dexmedetomidine for the Treatment of Alcohol Withdrawal Syndrome: Rationale and Current Status of Research

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Abstract

Dexmedetomidine is currently used in the US in the treatment of alcohol withdrawal syndrome (AWS) in the intensive care unit (ICU) setting, although data to support this practice are limited. Dexmedetomidine targets the noradrenergic system, an important but frequently overlooked secondary mechanism in the development of AWS, and, in doing so, may reduce the need for excessive benzodiazepine use which can increase the risk of γ-aminobutyric acid (GABA)-mediated deliriogenesis and respiratory depression. The purpose of this narrative review is to evaluate available literature reporting on the safety and efficacy of dexmedetomidine for AWS in the ICU setting. An English-language MEDLINE search (1966 to July 2013) was performed to identify articles evaluating the efficacy and safety of dexmedetomidine for AWS. Case series, case reports and controlled trials were evaluated for topic relevance and clinical applicability. Reference lists of articles retrieved through this search were reviewed to identify any relevant publications. Studies focusing on the safety and efficacy of dexmedetomidine for AWS in humans were selected. Studies were included if they were published as full articles; abstracts alone were not included in this review. Eight published case studies and case series were identified. Based on a limited body of evidence, dexmedetomidine shows promise as a potentially safe and possibly effective adjuvant treatment for AWS in the ICU. Prospective, well-controlled studies are needed to confirm the safety and efficacy of the use of dexmedetomidine in AWS.

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Financial disclosure

No financial support was received for this publication. Drs. Kerns and Gagliardi have no sources of financial support relevant to this publication. Drs. Muzyk and Brudney are on the speaker’s bureau for Hospira (manufacturer of Precedex® brand of dexmedetomidine).

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This article (in part or in whole) has not been previously presented or published.

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Authors and Affiliations

  1. Department of Pharmacy Practice, Campbell University School of Pharmacy and Health Sciences, P.O. Box 3089, Buies Creek, NC, 27710, USA

    Andrew J. Muzyk

  2. Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA

    Andrew J. Muzyk, Suzanne Kerns & Jane P. Gagliardi

  3. Durham VAMC Surgical Intensive Care Unit, Durham, NC, USA

    Scott Brudney

  4. Department of Medicine, Duke University, Durham, NC, USA

    Jane P. Gagliardi

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  1. Andrew J. Muzyk
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Correspondence to Andrew J. Muzyk.

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Muzyk, A.J., Kerns, S., Brudney, S. et al. Dexmedetomidine for the Treatment of Alcohol Withdrawal Syndrome: Rationale and Current Status of Research. CNS Drugs 27, 913–920 (2013). https://doi.org/10.1007/s40263-013-0106-6

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