The findings presented here are from the first reported comparison and double-blind evaluation of 20 patients randomly assigned to either chlordiazepoxide (n = 10) or clonidine (n = 10) for the treatment of acute alcohol withdrawal syndrome. Analysis of the study data demonstrated more favorable scores on tests of alcohol withdrawal symptoms (AWS), and better control of blood pressure, pulse, and respiratory rate with clonidine than with chlordiazepoxide therapy. In all other comparisons, clonidine was at least as efficacious. Clonidine may 'represent a new and possibly even superior pharmacologic treatment in the management of acute alcohol withdrawal syndrome.