• Corpus ID: 23583524

Outpatient management of alcohol withdrawal syndrome.

@article{Muncie2013OutpatientMO,
  title={Outpatient management of alcohol withdrawal syndrome.},
  author={Herbert L. Muncie and Yasmin Yasinian and Linda K Oge'},
  journal={American family physician},
  year={2013},
  volume={88 9},
  pages={
          589-95
        }
}
Approximately 2% to 9% of patients seen in a family physician's office have alcohol dependence. These patients are at risk of developing alcohol withdrawal syndrome if they abruptly abstain from alcohol use. Alcohol withdrawal syndrome begins six to 24 hours after the last intake of alcohol, and the signs and symptoms include tremors, agitation, nausea, sweating, vomiting, hallucinations, insomnia, tachycardia, hypertension, delirium, and seizures. Treatment aims to minimize symptoms, prevent… 

Figures and Tables from this paper

Alcohol withdrawal syndrome: diagnostic and therapeutic methods.
TLDR
Support to patient with AWS includes pharmacological intervention as well as general support, restoration of biochemical imbalances and specific therapy, in particular long-acting benzodiazepines, administered with a gradual reduction up to cessation.
Identification and Management of Alcohol Withdrawal Syndrome
TLDR
The gold-standard treatment for AWS is with benzodiazepines, and drugs, such as α2-agonists (clonidine and dexmetedomidine) and β-blockers can be used as adjunctive treatments to control neuroautonomic hyperactivity.
Diagnosis and treatment of acute alcohol intoxication and alcohol withdrawal syndrome: position paper of the Italian Society on Alcohol
TLDR
A task force of specialists drew up recommendations for the treatment of alcohol withdrawal syndrome with the following main results: while mild AWS may not require treatment, moderate and severe AWS need to be pharmacologically treated.
Evaluating the Use of Phenobarbital for the Management of Alcohol Withdrawal Syndrome in Psychiatric Inpatients
TLDR
Phenobarbital was safe, not leading to severe adverse effects or requiring a higher level of care, and efficacious for the prevention and treatment of AWS in this cohort of psychiatric inpatients.
Delirium Tremens: Assessment and Management.
Risk Factors for Severe Alcohol Withdrawal Syndrome in an Acute Hospital Population.
TLDR
Findings confirm that noninvasive variables collected in the emergency department are useful in identifying a person's risk of developing severe alcohol withdrawal syndrome (SAWS).
A multidisciplinary approach to the management of liver disease and alcohol disorders in psychiatric settings (Review)
TLDR
The possibility of treating alcohol use disorder and alcohol withdrawal syndrome overlapping alcohol liver disease (ALD) within a psychiatric institution, and the importance of a collaborative multidisciplinary team; correctly dosing psychoactive medication when metabolism is affected by ALD; deciding when is it necessary to seek a transfer to a general hospital.
Is medical treatment of Alcohol Withdrawal Syndrome a Stag Hunt? Challenges and opportunities in managing risk and uncertainty in addiction cessation
TLDR
The effect of cooperation is distinct from the effect of time in AWS and other addiction-cessation programs, and simulation games, such as the Stag Hunt, offer a viable framework to understand patient and provider incentives and health-affecting behaviors during treatments for addiction cessation.
A Systematic Review of Treatment Modalities for Alcohol Use Disorder
TLDR
Despite a large variety of options, the current research evidence is not strong enough to identify optimal treatment strategies for diverse populations, and it is clear that there are multiple possible treatment modalities for alcohol use disorders.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 46 REFERENCES
The alcohol withdrawal syndrome
TLDR
Although AWS may be complex, careful evaluation and available treatments should ensure safe detoxification for most patients.
Ambulatory detoxification of patients with alcohol dependence.
Detoxification from alcohol can be undertaken in ambulatory settings with patients who are alcohol-dependent and show signs of mild to moderate withdrawal when they are not drinking. An appropriate
Treatment of Alcohol Withdrawal
Appropriate treatment of alcohol withdrawal (AW) can relieve the patient’s discomfort, prevent the development of more serious symptoms, and forestall cumulative effects that might worsen future
Symptom-triggered vs fixed-schedule doses of benzodiazepine for alcohol withdrawal: a randomized treatment trial.
TLDR
Symptom-triggered benzodiazepine treatment for alcohol withdrawal is safe, comfortable, and associated with a decrease in the quantity of medication and duration of treatment.
The effects of carbamazepine and lorazepam on single versus multiple previous alcohol withdrawals in an outpatient randomized trial
TLDR
Caramazepine was superior to lorazepam in preventing rebound withdrawal symptoms and reducing post-treatment drinking, especially for those with a history of multiple treated withdrawals, and carbamazepines were equally effective at decreasing the symptoms of alcohol withdrawal.
Nonpharmacologic intervention in acute alcohol withdrawal
TLDR
It is indicated that most outpatients in mild to moderate alcohol withdrawal without medical complications improve without drug therapy in the emergency department setting.
Individualized treatment for alcohol withdrawal : a randomized double-blind controlled trial
TLDR
Symptom-triggered therapy individualizes treatment, decreases both treatment duration and the amount of benzodiazepine used, and is as efficacious as standard fixed-schedule therapy for alcohol withdrawal.
Anticonvulsants for alcohol withdrawal.
TLDR
Results of this review do not provide sufficient evidence in favour of anticonvulsants for the treatment of AWS, with some suggestions that carbamazepine may actually be more effective in treating some aspects of alcohol withdrawal when compared to benzodiazepines, the current first-line regimen for alcohol withdrawal syndrome.
Benzodiazepines for alcohol withdrawal.
TLDR
Benzodiazepines showed a protective benefit against alcohol withdrawal symptoms, in particular seizures, when compared to placebo and a potentially protective benefit for many outcomes when compared with other drugs.
Alcohol Withdrawal Syndrome
TLDR
The optimal care of patients with alcohol withdrawal syndrome is dependent on a multidisciplinary approach to provide appropriate evaluation, treatment, and follow-up.
...
1
2
3
4
5
...