Managing Alcohol Withdrawal in the Elderly

  title={Managing Alcohol Withdrawal in the Elderly},
  author={Kevin L Kraemer and Joseph Conigliaro and Richard Saitz},
  journal={Drugs \& Aging},
The alcohol withdrawal syndrome is common in elderly individuals who are alcohol dependent and who decrease or stop their alcohol intake. While there have been few clinical studies to directly support or refute the hypothesis that withdrawal symptom severity, delirium and seizures increase with advancing age, several observational studies suggest that adverse functional and cognitive complications during alcohol withdrawal do occur more frequently in elderly patients. Most elderly patients with… 
Treatment Of The Hospitalized Alcohol-Dependent Patient With Alcohol Withdrawal Syndrome
The objective of this manuscript was to review the contemporary literature regarding treatment of these conditions and distill the knowledge into useful clinical information for a practicing physician to simplify the management and treatment goals for the internal medicine physician for patients with alcohol-related disorders.
Inpatient alcohol withdrawal syndrome.
Seizures in Alcohol-Dependent Patients
The first seizure not related to alcohol withdrawal should not result in permanent drug treatment in an alcohol-dependent patient, because of poor compliance and the high likelihood of remission, and the treatment of alcohol dependence should be prioritised before the prevention of further seizures.
Independent Clinical Correlates of Severe Alcohol Withdrawal
Several readily available clinical variables correlate with the occurrence of severe alcohol withdrawal and Ascertainment of these variables early in the course of alcohol withdrawal has the potential to improve triage and treatment decisions.
Alcohol Use, Abuse, and Dependence in Elderly Populations
Three clinical articles related to alcohol use in the elderly that attempt to provide guidance to the clinician are critically evaluated.
Alcohol Use in an Older Adult Referred to a Consultation-Liaison Psychiatry Service: A Case Report
A 77-year-old female presented to a metropolitan hospital with symptoms including frequent falls, slurred speech, difficulty judging distance, hypersomnia, poor reasoning, and odd behaviours, and a consultation-liaison psychiatry assessment revealed a prominent heavy drinking pattern and concurrent abuse of oxycodone and benzodiazepines.
Psychiatric emergencies in the elderly population.
The severity of alcohol withdrawal is not age dependent.
The average severity of AWS did not differ between age groups, but daily alcohol intake and frequency of drinking were higher in younger alcoholics, but even when adjustment was made for this, severity was equal in both age groups.
Alcohol-induced persistent mild cognitive impairment with successful withdrawal from alcohol dependence--a case report.
An 81-year-old man diagnosed with alcohol-induced persistent mild cognitive impairment consulted the authors' clinic presenting with gait disturbance and is presently doing well after 1 year 2 months of treatment.
Delirium tremens in the elderly: Emerging role of dexmedetomidine
The current review is aimed at defining the appropriate management of clinical conundrums that frequently accompany alcohol abuse in the elderly, leading to increased morbidity and mortality and emphasizes the emerging role of dexmedetomidine in treating the elderly with DTs.


Severity and treatment of alcohol withdrawal in elderly versus younger patients.
It is concluded that alcohol withdrawal may be more severe in elderly than in younger persons and treatment may take longer and should target the specific profile of symptoms that characterize alcohol withdrawal in the elderly.
Development of optimal treatment tactics for alcohol withdrawal. I. Assessment and effectiveness of supportive care.
Three quarters of hospitalized patients, without serious medical complications, in alcohol withdrawal respond to intensive supportive care, however, pharmacotherapy is essential for nonresponders and patients with hallucinations.
Late-onset seizures in alcohol withdrawal.
Clinical characteristics of the seizures in patients treated with a standardized protocol of short-acting benzodiazepines are different from that classically described in untreated patients, with the seizures being closely related to the cessation of oxazepam rather than the cessationof alcohol.
Benzodiazepine requirements during alcohol withdrawal syndrome: clinical implications of using a standardized withdrawal scale.
Use of the scale appears to minimize both under- and overdosing with benzodiazepine for alcohol withdrawal syndrome, and suggest that when the scale is used, patients with a greater degree of physical dependence receive a higher dose of benzidiazepine and those with a lesser degree of dependence receive (appropriately) a lower dose.
Pharmacotherapies for alcohol abuse. Withdrawal and treatment.
It is most urgently needed for symptoms arising in the acute abstinence phase directly after the withdrawal of alcohol when the symptoms are most pronounced, i.
A clinical review of alcohol, alcoholism, and the elderly patient.
  • M. Schuckit
  • Medicine, Psychology
    The Journal of clinical psychiatry
  • 1982
The older alcoholic rarely fits the stereotype of alcoholism, tends to report stable early life adjustment, presents with restricted areas of alcohol-related pathology, and is likely to drink only 5-6 days a week, with an intake of 4-5 drinks per occasion.
Benzodiazepines for Alcohol Withdrawal in the Elderly and in Patients With Liver Disease
Lorazepam appears to be the safest empiric choice among the various benzodiazepines for treating AWS in the elderly and in patients with liver disease, or those who require therapy by the intramuscular route.