title: Alcohol withdrawal syndrome: symptom-triggered versus fixed-schedule treatment in an outpatient setting.
abstract: OBJECTIVE
  To investigate whether, in the treatment with chlordiazepoxide for outpatient alcohol withdrawal, there are advantages of symptom-triggered self-medication over a fixed-schedule regimen.
  
  
  METHODS
  A randomized controlled trial in outpatient clinics for people suffering from alcohol dependence (AD) and alcohol-related problems; 165 adult patients in an outpatient setting in a specialized alcohol treatment unit were randomized 1:1 to either a symptom-triggered self-medication or tapered dose, using chlordiazepoxide. Alcohol withdrawal symptoms, amount of medication, duration of symptoms, time to relapse and patient satisfaction were measured. Patients assessed their symptoms using the Short Alcohol Withdrawal Scale (SAWS). Patient satisfaction was monitored by the Diabetes Treatment Satisfaction Questionnaire. We used the Well-Being Index and the European addiction severity index for the 1-year follow-up.
  
  
  RESULTS
  We found no differences in the quantity of medication consumed, time to relapse, well being or treatment satisfaction.
  
  
  CONCLUSIONS
  Symptom-triggered self-medication was as safe as fixed-schedule medication in treating outpatients with AD and mild to moderate symptoms of AWS. The SAWS is a powerful monitoring tool, because it is brief and permits the subject to log the withdrawal symptoms.
authors.affiliation: Alcohol Unit, Copenhagen University Hospital, Hvidovre, Capital Region, Copenhagen, Denmark.
authors.forename: Bjarne
authors.initials: B
authors.lastname: Elholm
authors.forename: Klaus
authors.initials: K
authors.lastname: Larsen
authors.forename: Nete
authors.initials: N
authors.lastname: Hornnes
authors.forename: Finn
authors.initials: F
authors.lastname: Zierau
authors.forename: Ulrik
authors.initials: U
authors.lastname: Becker
mesh_terms: D000328:Adult; D000368:Aged; D000430:Alcohol Withdrawal Delirium / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D020751:Alcohol-Induced Disorders / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D000437:Alcoholism / Q000150:complications / Q000188:drug therapy*; D000553:Ambulatory Care; D016739:Behavior, Addictive; D002492:Central Nervous System Depressants / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D002707:Chlordiazepoxide / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D000431:Ethanol / Q000009:adverse effects / Q000494:pharmacology; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D055815:Young Adult
chemical_list: D002492:Central Nervous System Depressants; D006993:Hypnotics and Sedatives; D000431:Ethanol; D002707:Chlordiazepoxide