Diazepam and paraldehyde for treatment of severe delirium tremens. A controlled trial.
Thirty-four patients with severe delirium tremens were allocated randomly to treatment with paraldehyde (10 ml rectally very 30 minutes) or diazepam (10 mg then 5 mg intravenously every 5 minutes) until they were calm but awake. Diazepam-treated patients became calm in one half the time needed to calm patients with paraldehyde. Half of the patients had delirium tremens in association with pneumonia, pancreatitis, or alcoholic hepatitis; these patients required twice as much paraldehyde or diazepam for initial calming as patients with delirium tremens alone. Maintenance of a calm state was accomplished easily with either diazepam, intramuscularly, or paraldehyde, rectally. Adverse reactions occurred in nine patients, all of whom had been treated with paraldehyde; these patients had greater degrees of fever, tachypnea, and tachycardia and required three times longer for initial calming than patients without adverse reactions. Diazepam given under this regimen is a safe and effective sedative for management of combative patients with severe delirium tremens.
D000328:Adult; D000430:Alcohol Withdrawal Delirium / Q000188:drug therapy* / Q000209:etiology; D000437:Alcoholism / Q000150:complications; D002986:Clinical Trials as Topic; D003975:Diazepam / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006505:Hepatitis / Q000209:etiology; D006801:Humans; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications; D010242:Paraldehyde / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011014:Pneumonia / Q000150:complications; D011604:Psychoses, Alcoholic / Q000188:drug therapy*; D012007:Rectum; D013997:Time Factors
D003975:Diazepam; D010242:Paraldehyde