Enterosorbents in the combination therapy of alcohol withdrawal syndrome

Introduction. Alcohol withdrawal syndrome (AWS) remains one of the most significant clinical problems in addiction medicine, and the search for additional evidence-based therapeutic approaches remains relevant. One such approach may be the use of enterosorbents.

Aim. To determine the effectiveness of including an enterosorbent in the combination therapy of alcohol withdrawal syndrome.

Materials and methods. The study included 60 patients with alcohol withdrawal syndrome who were randomized into two groups of 30 patients each: a standard therapy group and a standard therapy plus colloidal silicon dioxide group. Treatment efficacy was assessed on days 7 and 14 based on changes in clinical symptoms, evaluated using the HAM-A, MFI-20, OCDS, and BIS-11 scales, and laboratory parameters. The severity of alcohol withdrawal syndrome was assessed daily for 7 days using the CIWA-Ar scale.

Results. No statistically significant between-group differences in total CIWA-Ar scores were found on any individual day of observation. The addition of colloidal silicon dioxide was associated with a reduction in anxiety according to the HAM-A scale as early as day 7, and this effect persisted until day 14. The main group also showed a more pronounced reduction in asthenic symptoms according to the MFI-20 scale. Analysis of the obsessive and compulsive components of pathological alcohol craving assessed by the Obsessive-Compulsive Drinking Scale showed statistically significant between-group differences over the day 1 to day 14 interval. The BIS-11 score decreased in both groups by days 7 and 14 of therapy. In the main group, decreases in gamma-glutamyl transferase levels were observed on days 7 and 14, and total bilirubin levels decreased by day 14.

Conclusions. The inclusion of colloidal silicon dioxide in the combination therapy of alcohol withdrawal syndrome was associated with a more pronounced reduction in anxiety and asthenic symptoms, a decrease in obsessive-compulsive alcohol craving by day 14 of therapy, and a more favorable trend in selected biochemical parameters.

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