Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Kattimani, Shivanand, Bharadwaj, Balaji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
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
_version_ 1782324707736944640
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