title: Identification and management of alcohol withdrawal syndrome.
abstract: Symptoms of alcohol withdrawal syndrome (AWS) may develop within 6-24 h after the abrupt discontinuation or decrease of alcohol consumption. Symptoms can vary from autonomic hyperactivity and agitation to delirium tremens. The gold-standard treatment for AWS is with benzodiazepines (BZDs). Among the BZDs, different agents (i.e., long-acting or short-acting) and different regimens (front-loading, fixed-dose or symptom-triggered) may be chosen on the basis of patient characteristics. Severe withdrawal could require ICU admission and the use of barbiturates or propofol. Other drugs, such as α2-agonists (clonidine and dexmetedomidine) and β-blockers can be used as adjunctive treatments to control neuroautonomic hyperactivity. Furthermore, neuroleptic agents can help control hallucinations. Finally, other medications for the treatment for AWS have been investigated with promising results. These include carbamazepine, valproate, sodium oxybate, baclofen, gabapentin and topiramate. The usefulness of these agents are discussed.
authors: Alcohol Use Disorders Unit, Department of Internal Medicine, Institute of Internal Medicine, Gemelli Hospital, Catholic University of Rome, Largo Gemelli 8, 00168, Rome, Italy.
authors: Antonio
authors: A
authors: Mirijello
authors: Cristina
authors: C
authors: D'Angelo
authors: Anna
authors: A
authors: Ferrulli
authors: Gabriele
authors: G
authors: Vassallo
authors: Mariangela
authors: M
authors: Antonelli
authors: Fabio
authors: F
authors: Caputo
authors: Lorenzo
authors: L
authors: Leggio
authors: Antonio
authors: A
authors: Gasbarrini
authors: Giovanni
authors: G
authors: Addolorato
mesh_terms: D018674:Adrenergic Antagonists / Q000008:administration & dosage; D000430:Alcohol Withdrawal Delirium / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D000437:Alcoholism / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D000818:Animals; D014150:Antipsychotic Agents / Q000008:administration & dosage; D001569:Benzodiazepines / Q000008:administration & dosage; D019468:Disease Management; D004359:Drug Therapy, Combination; D006801:Humans; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D018674:Adrenergic Antagonists; D014150:Antipsychotic Agents; D001569:Benzodiazepines