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Diagnosis and management of acute alcohol withdrawal

Holbrook, Anne M., Crowther, Renée, Lotter, Ann, Cheng, Chiachen and King, Derek (1999) Diagnosis and management of acute alcohol withdrawal. Canadian Medical Association Journal, 160 (5). pp. 675-680. ISSN 0820-3946

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Abstract

Alchol abuse produces a considerable burden of illness in the Canadian population. The diagnosis of alcohol dependence and withdrawal can be difficult, particularly in the setting of covert intake or comorbidity. Two validated scales, the CAGE questionnaire to screen for alcohol abuse and dependence and the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale to assess the severity of withdrawal, are valuable tools for clinicians to use on a regular basis. For the treatment of alcohol withdrawal, compelling anecdotal evidence supports the routine administration of thiamine, but not necessarily other vitamins. Phenytoin has not been shown to be superior to placebo for uncomplicated withdrawal seizures. Neuroleptics are not recommended for routine use. Sedation with benzodiazepines guided by the CIWA-Ar results is recommended. There is good evidence that the management of alcohol withdrawal can be improved with the routine use of the CIWA-Ar scale to assess severity, treatment with adequate doses of benzodiazepines and follow-up monitoring of patients in alcohol withdrawal.

Item Type: Article
Official URL: http://www.cmaj.ca/
Additional Information: © 1999 Canadian Medical Association
Library of Congress subject classification: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine
Sets: Research centres and groups > Personal Social Services Research Unit (PSSRU)
Rights: http://www.lse.ac.uk/library/usingTheLibrary/academicSupport/OA/depositYourResearch.aspx
Date Deposited: 21 Dec 2010 11:48
URL: http://eprints.lse.ac.uk/31017/

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