Alcohol Withdrawal: What is the Benzodiazepine of Choice?

@article{Bird1994AlcoholWW,
  title={Alcohol Withdrawal: What is the Benzodiazepine of Choice?},
  author={Ralph Daniel Bird and Eugene H. Makela},
  journal={Annals of Pharmacotherapy},
  year={1994},
  volume={28},
  pages={67 - 71}
}
OBJECTIVE: To review the literature concerning the use of benzodiazepines for treatment of alcohol withdrawal and to determine if the current literature assessment justifies the use of lorazepam as first-line therapy. DATA SOURCES: A thorough review of the literature was performed with an online database (BRS Colleague). Articles directed at the targeted issue were chosen and additional references were obtained from the bibliographies of these articles. STUDY SELECTION: Clinical trials and case… Expand
Effect of variations in treatment regimen and liver cirrhosis on exposure to benzodiazepines during treatment of alcohol withdrawal syndrome
TLDR
Differences in treatment regimens, the choice of BDZ, as well as the presence of liver cirrhosis can substantially alter the exposure of patients to drugs used for AWS treatment. Expand
Benzodiazepine treatment for alcohol-dependent patients.
TLDR
The clinical reality is that many alcoholics are treated by BZDs during detoxification and then continue to receive them for the treatment of anxiety disorders or insomnia, often secondary to alcohol dependence, and this review discusses the major indications for BZD treatment of alcoholism. Expand
A comparative study of the clinical efficacy and safety of Lorazepam and chlordiazepoxide in alcohol dependence syndrome.
TLDR
Lorazepam is noninferior to chlordiazepoxide in reducing alcohol withdrawal symptoms and there was no significant difference observed in the liver function tests done at baseline and at the end of study period. Expand
Inpatient Management of Acute Alcohol Withdrawal Syndrome
TLDR
Alcohol withdrawal is a common condition encountered in the hospital setting after abrupt discontinuation of alcohol in an alcohol-dependent individual and management revolves around early identification of at-risk individuals and symptom assessment using a validated tool such as the revised Clinical Institute Withdrawal Assessment for Alcohol score. Expand
AN OPEN LABEL COMPARISON OF CHLORDIAZEPOXIDE AND LORAZEPAM IN ALCOHOL WITHDRAWAL
TLDR
Lorazepam is more effective than chlordiazepoxide in alcohol withdrawal in both faster rate of fall of withdrawal severity and bringing down the total duration of withdrawal. Expand
Benzodiazepine loading versus symptom-triggered treatment of alcohol withdrawal: a prospective, randomized clinical trial.
TLDR
This study did not reveal clear evidence of a clinical advantage for choosing either treatment method in the management of alcohol withdrawal, and there was no significant difference in total benzodiazepine use between groups. Expand
Diazepam in the Treatment of Moderate to Severe Alcohol Withdrawal
TLDR
The comparative pharmacokinetics of the benzodiazepines used in the treatment of alcohol withdrawal together with a comprehensive review of the literature on their use strongly suggest that diazepam should be the preferred Benzodiazepine for the Treatment of patients experiencing moderate to severe alcohol withdrawal under most circumstances. Expand
Managing Alcohol Withdrawal in the Elderly
TLDR
To ensure appropriate benzodiazepine treatment, dose and frequency should be individualised with frequent monitoring, and based on validated alcohol withdrawal severity measures, the age of the patient should not deter clinicians from helping the patient achieve successful alcohol treatment and rehabilitation. Expand
To the Editor
TO THE EDITOR: We congratulate Bird and Makela for a comprehensive, timely, and important review of the use of benzodiazepines for the management of alcohol withdrawal syndrome (AWS ).1 We agree withExpand
A prospective, randomized, trial of phenobarbital versus benzodiazepines for acute alcohol withdrawal.
TLDR
Phenobarbital and LZ were similarly effective in the treatment of mild/moderate alcohol withdrawal in the ED and at 48 hours. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 22 REFERENCES
Double-blind comparison of lorazepam and chlordiazepoxide in the treatment of the acute alcohol abstinence syndrome.
TLDR
Because of its simpler and more predictable metabolic pathway and its insignificant accumulation in plasma during multiple-dose therapy, lorazepam may be the drug of choice if benzodiazepine therapy is required for chronic alcoholics with acute withdrawal symptoms. Expand
Management of the alcohol withdrawal syndrome.
People who suffer acute alcohol withdrawal should be admitted to a hospital if they have a concurrent medical or surgical complication or severe symptoms. Careful assessment, supportive care, andExpand
A double-blind comparison of the efficacy and safety of lorazepam and diazepam in the treatment of the acute alcohol withdrawal syndrome.
TLDR
It is indicated that lorazepam is as effective as diazepam in reducing the symptoms of acute alcohol withdrawal and may have therapeutic advantages for the management of the acutecohol withdrawal syndrome. Expand
Optimizing drug treatment of alcohol withdrawal.
TLDR
An optimal drug treatment regimen is formulated that minimizes the risks of complications during the drug treatment of alcohol withdrawal, while remaining highly effective. Expand
Benzodiazepines: a summary of pharmacokinetic properties.
TLDR
Drugs in this category have long-acting pharmacologically active metabolites, accumulate extensively during multiple dosage, and may have impaired clearance in the elderly and those with liver disease. Expand
Current Status of Benzodiazepines
TLDR
When the pharmacologic and clinical properties of the benzodiazepine sedative–anxioly tics were last reviewed comprehensively in 1973 and 1974, concern emerged among both prescribers and users of these medications about this continuously increasing use. Expand
Comparison of two benzodiazepines in the treatment of alcohol withdrawal: effects on symptoms and cognitive recovery.
Forty newly admitted alcohol-dependent patients were randomly allocated to equivalent 6-day regimes of either lorazepam or diazepam, to compare involvement in physical, emotional and cognitive stateExpand
Clinical Pharmacokinetics of Oxazepam and Lorazepam
TLDR
3-hydroxy benzodiazepine derivatives used as sedatives and anxiolytics and Oral and intramuscular lorazepam are rapidly absorbed, with systemic availability averaging 90 % or more. Expand
Clinical pharmacokinetics of chlordiazepoxide.
TLDR
Oral chlordiazepoxide is rapidly and completely absorbed, but intramuscular injection is painful and results in slow and erratic absorption, and the rate and extent of accumulation varies considerably between individuals. Expand
The alcohol-withdrawal syndrome.
  • C. Brown
  • Medicine
  • The Western journal of medicine
  • 1983
TLDR
A differential diagnosis and therapeutic guidelines for this disorder are outlined and the emergency physician who sees only one point in the spectrum of the patient's disease must be aware of the other clinical entities simulating its presentation. Expand
...
1
2
3
...