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Benzodiazepines are the mainstay of treatment for acute alcohol withdrawal syndrome

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Abstract

Benzodiazepines are first-line therapy for treatment of alcohol withdrawal syndrome (AWS). Longer acting benzodiazepines may provide a smoother withdrawal, while shorter-acting benzodiazepines may be preferred in patients who are elderly or have significant hepatic impairment. Front loading, fixed dose and symptom-triggered benzodiazepine dosing strategies may be used when treating moderate to severe AWS in the hospital setting. Other drugs may be appropriate as adjuncts to benzodiazepine therapy or in the treatment of mild to moderate AWS.

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References

  1. Perry EC. Inpatient management of acute alcohol withdrawal syndrome. CNS Drugs. 2014;28(5):401–10.

    Article  PubMed  CAS  Google Scholar 

  2. Carlson RW, Kumar NN, Wong-Mckinstry E, et al. Alcohol withdrawal syndrome. Crit Care Clin. 2012;28(4):549–85.

    Article  PubMed  Google Scholar 

  3. McKeon A, Frye MA, Delanty N. The alcohol withdrawal syndrome. J Neurol Neurosurg Psychiatry. 2008;79(8):854–62.

    Article  PubMed  CAS  Google Scholar 

  4. Sullivan JT, Sykora K, Schneiderman J, et al. Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Br J Addict. 1989;84(11):1353–7.

    Article  PubMed  CAS  Google Scholar 

  5. Amato L, Minozzi S, Vecchi S, et al. Benzodiazepines for alcohol withdrawal. Cochrane Database Syst Rev. 2010;3:CD005063.

    PubMed  Google Scholar 

  6. Holbrook AM, Crowther R, Lotter A, et al. Meta-analysis of benzodiazepine use in the treatment of acute alcohol withdrawal. CMAJ. 1999;160(5):649–55.

    PubMed  CAS  PubMed Central  Google Scholar 

  7. Saitz R, Mayo-Smith MF, Roberts MS, et al. Individualized treatment for alcohol withdrawal: a randomized double-blind controlled trial. JAMA. 1994;272(7):519–23.

    Article  PubMed  CAS  Google Scholar 

  8. Mayo-Smith MF, Beecher LH, Fischer TL, et al. Management of alcohol withdrawal delirium: an evidence-based practice guideline. Arch Intern Med. 2004;164(13):1405–12.

    Article  PubMed  CAS  Google Scholar 

  9. Hoffman RS, Weinhouse GL. Management of moderate and severe alcohol withdrawal syndromes. Topic 323 Version 23.0. 2013. http://www.uptodate.com/contents/management-of-moderate-and-severe-alcohol-withdrawal-syndromes. Accessed 2014.

  10. Mayo-Smith MF. Pharmacological management of alcohol withdrawal: a meta-analysis and evidence-based practice guideline. JAMA. 1997;278(2):144–51.

    Article  PubMed  CAS  Google Scholar 

  11. Keating GM. Sodium oxybate: a review of its use in alcohol withdrawal syndrome and in the maintenance of abstinence in alcohol dependence. Clin Drug Investig. 2014;34(1):63–80.

    Article  PubMed  CAS  Google Scholar 

  12. Kosten TR, O’Connor PG. Management of drug and alcohol withdrawal. N Engl J Med. 2003;348(18):1786–95.

    Article  PubMed  CAS  Google Scholar 

  13. Minozzi S, Amato L, Vecchi S, et al. Anticonvulsants for alcohol withdrawal. Cochrane Database Syst Rev. 2010;3:CD005064.

    PubMed  Google Scholar 

  14. Kirkwood CK, Melton ST. Anxiety disorders I: generalized anxiety, panic, and social anxiety disorders. In: Diro JT, Talert RL, Yee CG, et al., editors. Pharmacotherapy: a pathophysiological approach. 7th ed. New York: McGraw-Hill; 2008. p. 1161–78.

    Google Scholar 

Download references

Disclosure

This article was adapted from CNS Drugs 2014;28(5):401–10 [1] by salaried/contracted employees of Adis/Springer. The preparation of these articles was not supported by any external funding.

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Adis Medical Writers. Benzodiazepines are the mainstay of treatment for acute alcohol withdrawal syndrome. Drugs Ther Perspect 30, 395–398 (2014). https://doi.org/10.1007/s40267-014-0152-2

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  • DOI: https://doi.org/10.1007/s40267-014-0152-2

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