Magnesium in the treatment of alcohol withdrawal syndrome: a multicenter randomized controlled trial.

Publisher: Oxford University Press Country of Publication: England NLM ID: 8310684 Publication Model: Print Cited Medium: Internet ISSN: 1464-3502 (Electronic) Linking ISSN: 07350414 NLM ISO Abbreviation: Alcohol Alcohol Subsets: MEDLINE

Publication: <2003- > : Oxford : Oxford University Press
Original Publication: Oxford ; New York : Pergamon Press, c1983-

Magnesium*/administration & dosage ; Magnesium*/adverse effects ; Magnesium*/blood ; Magnesium*/therapeutic use ; Substance Withdrawal Syndrome*/complications ; Substance Withdrawal Syndrome*/drug therapy ; Alcoholism*/complications ; Alcoholism*/drug therapy; Humans ; Male ; Female ; Administration, Oral ; Double-Blind Method ; Benzodiazepines/therapeutic use ; Middle Aged ; Diarrhea/chemically induced

Objective: Alcohol withdrawal syndrome (AWS) is a frequent and potentially life-threatening condition experienced in alcohol use disorder. Since hypomagnesemia is involved in AWS's severity, we conducted a multicenter double-blind randomized placebo-controlled trial to examine the efficacy of oral magnesium supplementation as an adjuvant therapy of AWS.
Material and Methods: Inpatients were recruited in six different centers if they had a baseline score higher than eight on the Revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar). The experimental treatment was magnesium lactate dehydrate, administrated three times per day providing a total of 426.6 mg per day and up to 15 days. The primary endpoint was the significant between-group difference of the CIWA-Ar total score change from baseline to 3 days later. The treatment group and baseline score were introduced as covariables in an analysis of covariance.
Results: A total of 98 inpatients were included {71.4% of men; mean age of 49.1 years [standard deviation (SD): 10.3]}. In the intention-to-treat population, the mean reduction of the CIWA-Ar score in the experimental group between baseline and 3 days later was 10.1 (SD: 5.2), whereas it was 9.2 (SD: 3.9) in the control group. The absolute difference of the adjusted mean in the experimental group compared with the control group was -0.69 (SD: 0.72), which did not correspond to a significant between-group difference (P = 0.34). Per-protocol analysis and sensitivity analyses also supported this result. Supplementary analyses found no significant difference regarding benzodiazepine consumption, magnesium blood concentration, and satisfaction to care.
Conclusions: The present study does not support the rationale of systematic oral magnesium supplementation in patients with AWS.
(© The Author(s) 2023. Medical Council on Alcohol and Oxford University Press. All rights reserved.)

Comment in: Alcohol Alcohol. 2023 Sep 9;58(5):570. doi: 10.1093/alcalc/agad040. (PMID: 37311572)

French national PHRC

Keywords: alcohol use disorder; alcohol withdrawal syndrome; benzodiazepine; magnesium; randomized controlled trial

I38ZP9992A (Magnesium)
12794-10-4 (Benzodiazepines)

Date Created: 20230404 Date Completed: 20230516 Latest Revision: 20230912

20250114

10.1093/alcalc/agad021

37012631