Subject
*Gabapentin
*Benzodiazepine abuse
*Methadone abuse
*Drug abstinence
*Edema
*Therapeutics
*Methadone treatment programs
*Substance abuse treatment
*Amines
*GABA
*Carbocyclic acids
*Benzodiazepines
*Combined modality therapy
*Comparative studies
*Drug withdrawal symptoms
*Research methodology
*Medical cooperation
*Psychotherapy
*Research
*Research funding
*Substance abuse
*Tranquilizing drugs
*Pilot projects
*Evaluation research
*Randomized controlled trials
*Blind experiment
Abstract
Background: Benzodiazepine use disorders are a common clinical problem among methadone maintenance treatment patients and have adverse effects on clinical outcomes.Objectives: To evaluate gabapentin for the outpatient treatment of benzodiazepine abuse or dependence in methadone maintenance patients.Methods: Participants (n = 19) using benzodiazepines at least 4 days per week were enrolled into an 8-week randomized double-blind placebo-controlled outpatient pilot trial. All participants received a manual-guided supportive psychotherapy aimed to promote abstinence. Study medication was titrated over a 2-week period to a maximum dose of gabapentin 1200 mg or placebo three times a day. Benzodiazepine use was assessed using urine toxicology confirmed self-report. Benzodiazepines were not provided as part of study participation; participants were provided guidance to gradually reduce benzodiazepine intake.Results: Sixteen participants had post-randomization data for analysis. Retention at week eight was 50%. The mean dose of gabapentin achieved by titration was 2666 mg/day (SD = ± 1446). There were no significant between group differences on benzodiazepine use outcomes (amount benzodiazepine per day [Mann-Whitney U = 27, p = 0.745], abstinent days per week [U = 28, p = 0.811]) and Clinical Instrument Withdrawal Assessment (CIWA)-benzodiazepines scale (U = 29.0, p = 0.913). One participant in the gabapentin group discontinued study medication because of peripheral edema. Two participants in the placebo group requested admission for inpatient detoxification treatment.Conclusion: In outpatient methadone-maintained patients with benzodiazepine use disorder, gabapentin did significantly decrease benzodiazepine use relative to placebo. The small sample recruited for this trial may have limited the ability to detect a group difference. [ABSTRACT FROM AUTHOR]