Pharmacology Q24

Alcohol Withdrawal

 

Chlordiazepoxide is generally the first choice for alleviating acute alcohol withdrawal symptoms such as sweating, tremors, and altered mentation, possibly accompanied by hallucinations.

Addressing Severe Symptoms and Complications

1. Seizures and Delirium Tremens: If the individual experiences seizures or delirium tremens, characterized by hallucinations and confusion, Lorazepam can be administered. If IV Lorazepam is unavailable, Diazepam is an alternative.

2. Wernicke’s Encephalopathy: In the event of developing Wernicke’s encephalopathy, which manifests with symptoms such as confusion, ataxia, and ophthalmoplegia, the individual should receive Vitamin B1 (Thiamine) or a high-potency Vitamin B complex.

Maintenance Therapy

. Reducing Cravings: Acamprosate can be prescribed to help reduce the craving for alcohol.

. Deterrent Therapy: To encourage abstinence by creating an aversion to alcohol, Disulfiram can be used.

Summary

To summarize, the choice of medication depends on the specific needs and circumstances of the individual:

. For acute alcohol withdrawal symptoms:

i. First Line: Chlordiazepoxide + Thiamine (Vitamin B1)

ii. In case of seizures: Consider adding Lorazepam (IV Lorazepam preferred if available)

. If the individual wishes to find a medication that:

   i. Acts as a deterrent for alcohol consumption: Disulfiram.

   ii. Reduces alcohol craving: Acamprosate.

   iii. Alleviates withdrawal symptoms: Chlordiazepoxide.

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