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Clinical management of alcohol withdrawal: A systematic review
Alcohol withdrawal is commonly encountered in general hospital settings. It forms a major part of referrals received by a consultation-liaison psychiatrist. This article aims to review the evidence base for appropriate clinical management of the alcohol withdrawal syndrome. We searched Pubmed for ar...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085800/ https://www.ncbi.nlm.nih.gov/pubmed/25013309 http://dx.doi.org/10.4103/0972-6748.132914 |
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author | Kattimani, Shivanand Bharadwaj, Balaji |
author_facet | Kattimani, Shivanand Bharadwaj, Balaji |
author_sort | Kattimani, Shivanand |
collection | PubMed |
description | Alcohol withdrawal is commonly encountered in general hospital settings. It forms a major part of referrals received by a consultation-liaison psychiatrist. This article aims to review the evidence base for appropriate clinical management of the alcohol withdrawal syndrome. We searched Pubmed for articles published in English on pharmacological management of alcohol withdrawal in humans with no limit on the date of publication. Articles not relevant to clinical management were excluded based on the titles and abstract available. Full-text articles were obtained from this list and the cross-references. There were four meta-analyses, 9 systematic reviews, 26 review articles and other type of publications like textbooks. Alcohol withdrawal syndrome is a clinical diagnosis. It may vary in severity. Complicated alcohol withdrawal presents with hallucinations, seizures or delirium tremens. Benzodiazepines have the best evidence base in the treatment of alcohol withdrawal, followed by anticonvulsants. Clinical institutes withdrawal assessment-alcohol revised is useful with pitfalls in patients with medical comorbidities. Evidence favors an approach of symptom-monitored loading for severe withdrawals where an initial dose is guided by risk factors for complicated withdrawals and further dosing may be guided by withdrawal severity. Supportive care and use of vitamins is also discussed. |
format | Online Article Text |
id | pubmed-4085800 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-40858002014-07-10 Clinical management of alcohol withdrawal: A systematic review Kattimani, Shivanand Bharadwaj, Balaji Ind Psychiatry J Review Article Alcohol withdrawal is commonly encountered in general hospital settings. It forms a major part of referrals received by a consultation-liaison psychiatrist. This article aims to review the evidence base for appropriate clinical management of the alcohol withdrawal syndrome. We searched Pubmed for articles published in English on pharmacological management of alcohol withdrawal in humans with no limit on the date of publication. Articles not relevant to clinical management were excluded based on the titles and abstract available. Full-text articles were obtained from this list and the cross-references. There were four meta-analyses, 9 systematic reviews, 26 review articles and other type of publications like textbooks. Alcohol withdrawal syndrome is a clinical diagnosis. It may vary in severity. Complicated alcohol withdrawal presents with hallucinations, seizures or delirium tremens. Benzodiazepines have the best evidence base in the treatment of alcohol withdrawal, followed by anticonvulsants. Clinical institutes withdrawal assessment-alcohol revised is useful with pitfalls in patients with medical comorbidities. Evidence favors an approach of symptom-monitored loading for severe withdrawals where an initial dose is guided by risk factors for complicated withdrawals and further dosing may be guided by withdrawal severity. Supportive care and use of vitamins is also discussed. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC4085800/ /pubmed/25013309 http://dx.doi.org/10.4103/0972-6748.132914 Text en Copyright: © Industrial Psychiatry Journal http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Kattimani, Shivanand Bharadwaj, Balaji Clinical management of alcohol withdrawal: A systematic review |
title | Clinical management of alcohol withdrawal: A systematic review |
title_full | Clinical management of alcohol withdrawal: A systematic review |
title_fullStr | Clinical management of alcohol withdrawal: A systematic review |
title_full_unstemmed | Clinical management of alcohol withdrawal: A systematic review |
title_short | Clinical management of alcohol withdrawal: A systematic review |
title_sort | clinical management of alcohol withdrawal: a systematic review |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085800/ https://www.ncbi.nlm.nih.gov/pubmed/25013309 http://dx.doi.org/10.4103/0972-6748.132914 |
work_keys_str_mv | AT kattimanishivanand clinicalmanagementofalcoholwithdrawalasystematicreview AT bharadwajbalaji clinicalmanagementofalcoholwithdrawalasystematicreview |