{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:57:16Z","timestamp":1792112236052,"version":"4.4.0"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T00:00:00Z","timestamp":1620000000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000764","name":"King's College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000764","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Anti\u2010seizure medications (ASMs) have been used historically as treatment options in alcohol withdrawal syndrome (AWS). In the past 10\u00a0years, there have been no large\u2010scale meta\u2010analyses comparing ASMs with placebo or the current AWS treatment standard, benzodiazepines. We aimed to evaluate the efficacy and tolerability of ASMs in AWS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Systematic review and meta\u2010analysis of randomised controlled trials (RCTs) via searching Medline, Embase and PsychINFO from database inception to March 2020 involving adults age &gt;18\u00a0years with AWS. We included 24 RCTs reporting on a total of 2223 participants. Efficacy outcomes included the number of participants experiencing AWS related seizures or delirium, Clinical Institute Withdrawal Assessment for Alcohol\u2013Revised (CIWA\u2010Ar) score reduction and rescue medication requirements. Tolerability outcomes included adverse event rate and dropout because of adverse events, alongside severe and life\u2010threatening adverse event rates. Quality was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no evidence of significant improvements in any efficacy outcomes when comparing ASMs with placebo or benzodiazepines. When compared with benzodiazepines, ASMs demonstrated significantly increased odds of requiring rescue medications (OR = 3.50, 95% CI = 1.32, 9.28; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.012). When comparing ASMs with placebo, there were significantly more dropouts because of adverse events (OR = 1.86, 95% CI = 1.05, 3.28; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.034). Most results were of very low quality with the majority of included studies conducted before 2000.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This systematic review and meta\u2010analysis found no evidence to support general first line clinical use of anti\u2010seizure medications in alcohol withdrawal syndrome treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.15510","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T15:07:01Z","timestamp":1617721621000},"page":"5-18","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The effectiveness and tolerability of anti\u2010seizure medication in alcohol withdrawal syndrome: a systematic review, meta\u2010analysis and GRADE of the evidence"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4150-4048","authenticated-orcid":false,"given":"Jou\u2010Yin","family":"Lai","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Taipei City Psychiatric Center Taipei City Hospital Songde Branch  Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3820-9243","authenticated-orcid":false,"given":"Nicola","family":"Kalk","sequence":"additional","affiliation":[{"name":"National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London and South London and the Maudsley NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4152-5570","authenticated-orcid":false,"given":"Emmert","family":"Roberts","sequence":"additional","affiliation":[{"name":"National Addiction Centre and the Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience King's College London and South London and the Maudsley NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","unstructured":"JesseS. LudolphA.Alcohol withdrawal syndrome: Clinical picture and therapeutic options. Neuroscience of Alcohol: Mechanisms and Treatment. Elsevier Inc.;2019.671\u2013680p. Available from:https:\/\/doi.org\/10.1016\/B978\u20100\u201012\u2010813125\u20101.00069\u20106","DOI":"10.1016\/B978-0-12-813125-1.00069-6"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2017.02.002"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2017.03.012"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2017.11.007"},{"key":"e_1_2_8_6_1","unstructured":"National Institute for Health and Care Excellence.Alcohol\u2010use disorders: diagnosis and management of physical complications Clinical guideline [CG100]Published date: 02 June 2010 Last updated: 12 April2017. 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