Nimodipine and flunarizine in alcohol withdrawal: an open study

An open pilot study of the calcium antagonists nimodipine (240 mg/die p.o.) and flunarizine (20 mg/die p.o.) as a treatment in alcohol withdrawal was conducted. Two of the eight patients who received nimodipine and one of the eight patients who received flunarizine developed a confusional state preceded, in one of the patients with nimodipine and in the patient with flunarizine, by a generalized tonic-clonic seizure. The patients receiving flunarizine seemed to recover faster from the alcohol withdrawal syndrome than the patients receiving nimodipine. Given the limited capability of both drugs to prevent severe withdrawal symptoms at the doses tested, double-blind studies with these drugs, possibly with higher doses and i.v. administration should follow an add-on design.