Magnesium in the treatment of alcohol withdrawal syndrome: a multicenter randomized controlled trial.

OBJECTIVE: Alcohol withdrawal syndrome (AWS) is a frequent and potentially life-threatening condition experienced in alcohol use disorder. Since hypomagnesemia is involved in AWS's severity, we conducted a multicenter double-blind randomized placebo-controlled trial to examine the efficacy of oral magnesium supplementation as an adjuvant therapy of AWS. MATERIAL AND METHODS: Inpatients were recruited in six different centers if they had a baseline score higher than eight on the Revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar). The experimental treatment was magnesium lactate dehydrate, administrated three times per day providing a total of 426.6 mg per day and up to 15 days. The primary endpoint was the significant between-group difference of the CIWA-Ar total score change from baseline to 3 days later. The treatment group and baseline score were introduced as covariables in an analysis of covariance. RESULTS: A total of 98 inpatients were included {71.4% of men; mean age of 49.1 years [standard deviation (SD): 10.3]}. In the intention-to-treat population, the mean reduction of the CIWA-Ar score in the experimental group between baseline and 3 days later was 10.1 (SD: 5.2), whereas it was 9.2 (SD: 3.9) in the control group. The absolute difference of the adjusted mean in the experimental group compared with the control group was -0.69 (SD: 0.72), which did not correspond to a significant between-group difference (P = 0.34). Per-protocol analysis and sensitivity analyses also supported this result. Supplementary analyses found no significant difference regarding benzodiazepine consumption, magnesium blood concentration, and satisfaction to care. CONCLUSIONS: The present study does not support the rationale of systematic oral magnesium supplementation in patients with AWS.

Peer bullying victimization in adolescence is associated with substance use: cross-sectional findings from French high school students.

The relationships between peer bullying victimization in adolescence and substance use have been poorly studied. Thus, we examined the associations between peer bullying victimization and tobacco, alcohol and cannabis use in 496 French high school students. Peer bullying victimization was measured with a 17-item standardized assessment and analyzed as quartiles. Tobacco, alcohol, and cannabis use were assessed with the Hooked on Nicotine Checklist (HONC), the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and the Cannabis Abuse Screening Test (CAST), respectively. Total scores at the HONC (0 to 10), AUDIT-C (0 to 12), and CAST (0 to 24) were used as dependent variables in generalized linear models, adjusting for sex, age, prepared graduation, last school marks and friends outside high school. Compared to the first quartile (i.e., the least bullied students), those from the second, third and fourth quartiles had significant increase of the AUDIT-C (B = 0.78 [95%CI 0.17-1.40] with p = 0.013; B = 0.86 [95%CI 0.26;1.46] with p = 0.005 and B = 1.00 [95%CI 0.38;1.62] with p = 0.002, respectively), with dose-dependent relationships (B = 0.33 ([95%CI 0.13; 0.52] with p = 0.001). Those from the fourth quartile had a significant increase of the CAST (B = 2.13[95%CI 1.25;3.01], p < 0.001). When examining the role of peer bullying victimization on the number of substances used, there were significant increased odds for students from the third and fourth quartiles, with dose-dependent relationships (OR = 1.24 [95% CI 1.07;1.44], p = 0.005). These findings encourage paying a particular attention to substance use in students who report being bullied. Consequently, information and prevention using standardized screening tools should be proposed. Conversely, substance use could be an indicator of peer bullying victimization and should thus be explored.

A comprehensive model of predictors of suicide attempt in heavy drinkers: Results from a national 3-year longitudinal study.

BACKGROUND: Heavy drinkers are at high risk for suicide attempt and suicide. Multiple factors, when examined in isolation, have been implicated in the risk of suicide attempt in this population. In this report, we present a comprehensive model of the 3-year risk of suicide attempt in heavy drinkers using a longitudinal nationally representative study, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; wave 1, 2001-2002; wave 2, 2004-2005). METHODS: We used structural equation modeling to simultaneously examine effects of four broad groups of clinical factors previously identified as potential predictors of attempted suicides: 1) alcohol use disorder severity, 2) severity of comorbidity, 3) sociodemographic characteristics and 4) help-seeking for alcohol problems. Heavy drinking was defined as drinking 5 or more drinks in a day more than once a week in the month prior to Wave 1. RESULTS: About 1.5% of the 1573 heavy drinker participants (i.e., 5.1% of the NESARC sample) attempted suicide during the 3-year follow-up period. After adjusting for all other factors, several factors independently predicted attempted suicides: the alcohol use disorder liability factor measured by DSM-IV-TR criteria for alcohol abuse and dependence and two dimensions of psychopathology, the general psychopathology factor accounting for the shared effects of all comorbid psychiatric disorders and the externalizing dimension accounting for the shared effects of comorbid substance use disorders. No other factor predicted this risk in addition. CONCLUSION: This model may help identify individuals with heavy drinking at high risk of suicide and develop more effective suicide prevention strategies.