A Cochrane review included 13 studies, 11 of which were conducted in Italy, with a total of 648 subjects. Gamma-hydroxybutyrate (GHB) 50mg/kg/day was more effective than placebo for alcohol withdrawal symptoms (weighted mean difference WMD -12.1, 95% CI -15.9 to -8.29; 1 trial, n=23). The comparison with chlormetiazole favoured GHB for withdrawal symptoms (MD -3.40, 95% CI -5.09 to -1.71; 1 trial, n=21). GHB was as effective as benzodiazepines in the treatment of withdrawal symptoms (MD -0.73 ; -2.23 to 0.77; 1 trial, n=48). At mid-term (a person already detoxified), GHB was nonsignificantly better than placebo in 1 small trial for abstinence rate and relapses. The comparison with naltrexone or disulfiram for abstinence favoured GHB, however also these results were insignificant.
In another Cocrane review no strong differences were observed in the comparisons of GHB with placebo, benzodiazepines and anticonvulsants.
Comment: The quality of evidence is downgraded by several shortcomings in study quality, by imprecise results (limited study size for each comparison), by inconsistency (heterogeneity in interventions and outcomes), and by potential reporting bias.