알코올 금단 치료에서 아캄프로세이트와 마그네슘의 병용 효과

Acamprosate & Magnesium for the Treatment of Alcohol Withdrawal

Background：Magnesium (Mg) deficiency is known to be common for alcoholics. Earlier research suggests that Mg treatment may help to decrease the risk of delirium tremens (DT) and withdrawal symptoms among alcoholics but the evidence is still controversial. The purpose of this study is to investigate the ef-fects of magnesium in the treatment of alcohol withdrawal and DT. Method：A retrospective study was done by reviewing medical records of patients diagnosed as alcohol dependence ac-cording to DSM-IF diagnostic criteria between March 1st, 2007 and December 31st, 2008 at Incheon Christian Hospital. Total sixty five subjects met the purpose for this study, divided into two groups by use of Mg treatment：thirty one subjects for Mg treatment group and thirty four subjects for control (non Mg treatment) group. Through the chart review, all the demographic profiles and clinical data were obtained. At baseline, 1st, 2nd, 3rd week after admission, we examined complete blood count, liver function test, total dose of benzodiazepines of every week, occurrence and duration of withdrawal seizure & DT, and symptoms severity by using Clinical Institute Withdrawal Assessment for Alcohol (C-IWA-Ar). Results：1) To compare the two groups, there was no difference of demographic data. 2) Mg treatment groups showed lower total dose of benzodiazepines used during 1st week after admission than control groups. 3) Mg treatment groups showed lower DT frequency & duration even though does not reach a significant difference. 4) Mg treatment group showed more rapid decrease in total CIWA-Ar score but a significant difference begin to show after 3rd week compared to control group. 5) Among subtest of CIWA-Ar, sweating and anxiety score began to show a significant difference after 2nd week. Conclusion：This study showed that magnesium when combined with acamprosate could be one of the effective and beneficial treatment options of alcoholic withdrawal symptoms by reducing and stabilizing hyperexcitoto-xicity of the glutamate system. But further study using prospective and well controlled design is needed.