Drugs Used to Treat Withdrawal Syndromes

2018 ◽  
Author(s):  
Eelco F. M. Wijdicks ◽  
Sarah L. Clark
Keyword(s):  
Side Effects ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
Opioid Withdrawal ◽  
Baclofen Withdrawal ◽  
Withdrawal Syndromes

This chapter covers the treatment of withdrawal syndromes associated with alcohol, opioids, stimulants, baclofen, and nicotine. The approach to refractory withdrawal delirium is discussed, as well as the management of serious withdrawal syndromes that are neurology-specific, such as baclofen withdrawal. Withdrawal syndromes are serious and may require extensive pharmacotherapy. The safety of the patient must be balanced against the risks and side effects of the medications administered to control the agitation. Prior alcoholism accounts for the overwhelming proportion of patients with withdrawal syndromes. The drugs used for treatment of alcohol withdrawal syndrome include benzodiazepines, dexmedetomidine, and propofol. The prevalence of opioid withdrawal is increasing.

Mesoridazine and Chlorpromazine in the Treatment of Alcohol Withdrawal Syndrome

1973 ◽  
Vol 18 (5) ◽  
pp. 385-387
Author(s):  
J.B. Frost
Keyword(s):  
Side Effects ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Intoxication ◽  
Alcohol Withdrawal Syndrome ◽  
Acute Alcohol Intoxication ◽  
Double Blind ◽  
Therapeutic Regime ◽  
Significant Difference

Forty patients admitted for the treatment of alcohol withdrawal were placed on either chlorpromazine or mesoridazine on a double-blind basis. No significant difference in rate or degree of improvement between the two groups was noted and both groups showed an improvement which was more marked in the first week of treatment. There were few significant side effects from either drug. Improvement on either therapeutic regime is predictable and both are effective in relieving or lessening agitation, tremulousness, hallucinations and anxiety in patients recovering from acute alcohol intoxication.

Treatment of the Acute Alcohol-Withdrawal Syndrome

1958 ◽  
Vol 19 (1) ◽  
pp. 118-124 ◽  
Author(s):  
Lincoln Godfrey ◽  
Martin D. Kissen ◽  
Thomas M. Downs
Keyword(s):  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome

scholarly journals Should the CIWA-Ar be the standard monitoring strategy for alcohol withdrawal syndrome in the intensive care unit?

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Tessa L. Steel ◽  
Shewit P. Giovanni ◽  
Sarah C. Katsandres ◽  
Shawn M. Cohen ◽  
Kevin B. Stephenson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
Patient Characteristics ◽  
Response To Treatment ◽  
Alternative Measure ◽  
Icu Patients ◽  
Verbal Responses

Abstract Background The Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) is commonly used in hospitals to titrate medications for alcohol withdrawal syndrome (AWS), but may be difficult to apply to intensive care unit (ICU) patients who are too sick or otherwise unable to communicate. Objectives To evaluate the frequency of CIWA-Ar monitoring among ICU patients with AWS and variation in CIWA-Ar monitoring across patient demographic and clinical characteristics. Methods The study included all adults admitted to an ICU in 2017 after treatment for AWS in the Emergency Department of an academic hospital that standardly uses the CIWA-Ar to assess AWS severity and response to treatment. Demographic and clinical data, including Richmond Agitation-Sedation Scale (RASS) assessments (an alternative measure of agitation/sedation), were obtained via chart review. Associations between patient characteristics and CIWA-Ar monitoring were tested using logistic regression. Results After treatment for AWS, only 56% (n = 54/97) of ICU patients were evaluated using the CIWA-Ar; 94% of patients had a documented RASS assessment (n = 91/97). Patients were significantly less likely to receive CIWA-Ar monitoring if they were intubated or identified as Black. Conclusions CIWA-Ar monitoring was used inconsistently in ICU patients with AWS and completed less often in those who were intubated or identified as Black. These hypothesis-generating findings raise questions about the utility of the CIWA-Ar in ICU settings. Future studies should assess alternative measures for titrating AWS medications in the ICU that do not require verbal responses from patients and further explore the association of race with AWS monitoring.

Serum Concentration of Chlormethiazole and Therapeutic Effect in Acute Alcohol Withdrawal Syndrome: An Open Clinical Trial

2002 ◽  
Vol 24 (3) ◽  
pp. 446-454 ◽  
Author(s):  
Sven Ulrich ◽  
Peter Danos ◽  
Bruno Baumann ◽  
Dörthe Müller ◽  
Dörthe Lehmann ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Serum Concentration ◽  
Therapeutic Effect ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome

A254 POSTOPERATIVE ALCOHOL WITHDRAWAL SYNDROME PROPHYLAXIS VERSUS THERAPY

1990 ◽  
Vol 73 (3A) ◽  
pp. NA-NA
Author(s):  
Thomas Hell ◽  
Dirk Martens ◽  
Klaus Eyrlch
Keyword(s):  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome
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