FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 340:915-919 March 25, 1999 Number 12 Next

	Full Text PDF Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article by Sosis, M. B. PubMed Citation

ABSTRACT

Background and Methods Alcohol abuse is one of the most common causes of seizures in adults. In a randomized, double-blind study, we compared lorazepam with placebo for the prevention of recurrent seizures related to alcohol. Over a 21-month period, we studied consecutive patients with chronic alcohol abuse who were at least 21 years of age and who presented to the emergency departments of two hospitals in Boston after a witnessed, generalized seizure. The patients were randomly assigned to receive either 2 mg of lorazepam in 2 ml of normal saline or 4 ml of normal saline intravenously and then observed for six hours. The primary end point was the occurrence of a second seizure during the observation period.

Results Of the 229 patients who were initially evaluated, 186 met the entry criteria. In the lorazepam group, 3 of 100 patients (3 percent) had a second seizure, as compared with 21 of 86 patients (24 percent) in the placebo group (odds ratio for seizure with the use of placebo, 10.4; 95 percent confidence interval, 3.6 to 30.2; P<0.001). Forty-two percent of the placebo group were admitted to the hospital, as compared with 29 percent of the lorazepam group (odds ratio for admission, 2.1; 95 percent confidence interval, 1.1 to 4.0; P=0.02). Seven patients in the placebo group and one in the lorazepam group were transported to an emergency department in Boston with a second seizure within 48 hours after hospital discharge.

Conclusions Treatment with intravenous lorazepam is associated with a significant reduction in the risk of recurrent seizures related to alcohol.

Source Information

From the Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine (G.D., A.S.U., S.S.F., E.S.F.), and the Department of Emergency Medicine, Carney Hospital (N.K.R.) — both in Boston.

Address reprint requests to Dr. D'Onofrio at Yale University, 464 Congress Ave., New Haven, CT 06519.

Full Text of this Article

Related Letters:

Lorazepam for the Prevention of Recurrent Seizures Related to Alcohol
Sosis M. B., Matz R., D'Onofrio G., Rathlev N. K., Ulrich A. S.
Extract | Full Text  
N Engl J Med 1999; 341:609-610, Aug 19, 1999. Correspondence

This article has been cited by other articles:

• McKeon, A, Frye, M A, Delanty, N. (2008). The alcohol withdrawal syndrome. J. Neurol. Neurosurg. Psychiatry 79: 854-862 [Abstract] [Full Text]  
• Lingford-Hughes, A. R., Welch, S., Nutt, D. J. (2004). Evidence-Based Guidelines for the Pharmacological Management of Substance Misuse, Addiction and Comorbidity: Recommendations from the British Association for Psychopharmacology. J Psychopharmacol 18: 293-335  
• Chan, K. B.Y., Man-Son-Hing, M., Molnar, F. J., Laupacis, A. (2001). How well is the clinical importance of study results reported? An assessment of randomized controlled trials. CMAJ 165: 1197-1202 [Abstract] [Full Text]  
• Schwan, R., Reynaud, M. (1999). Intravenous lorazepam reduced alcohol related seizures in patients with chronic alcohol abuse. Evid. Based Ment. Health 2: 107-107 [Full Text]  
• Sosis, M. B., Matz, R., D'Onofrio, G., Rathlev, N. K., Ulrich, A. S. (1999). Lorazepam for the Prevention of Recurrent Seizures Related to Alcohol. NEJM 341: 609-610 [Full Text]  
• (1999). Lorazepam to Prevent Recurrent Alcohol-Related Seizures. JWatch Psychiatry 1999: 17-17 [Full Text]  
• (1999). Lorazepam Prevents Recurrent Alcohol-Related Seizures. JWatch Emergency Med. 1999: 1-1 [Full Text]  
• (1999). Lorazepam to Prevent Recurrent Alcohol-Related Seizures. JWatch General 1999: 4-4 [Full Text]