title: [Thiamine in patients with alcohol use disorder and Wernicke's encephalopathy].
abstract: - Patients with alcohol use disorder frequently have a thiamine deficiency.- A potential life-threatening complication of thiamine deficiency is Wernicke's encephalopathy.- Since it is clinically difficult to recognize Wernicke's encephalopathy, this condition is often treated inadequately. - Early supplementation of thiamine is important to avoid irreversible neurological damage. - There are differences between the Dutch guidelines regarding the supplementation of thiamine for the treatment of alcoholic use disorder, and those for Wernicke's encephalopathy. - There are no solid evidence-based recommendations about the best dosage, route of administration and duration of thiamine supplementation for the treatment of alcohol use disorder and Wernicke's encephalopathy. - Based on the pharmacokinetic properties of thiamine, it is more appropriate to give patients with alcohol use disorder 25 mg four times a day rather than 50 mg twice a day. - Patients at high risk of Wernicke's encephalopathy should immediately receive an intravenous or intramuscular dose of thiamine; patients with suspected Wernicke's encephalopathy should preferably receive an intravenous dose.- Reports of anaphylactic reaction to parenteral administration of thiamine are rare and are not a reason to refrain from parenteral treatment.
authors.affiliation: VU medisch centrum, Amsterdam.
authors.forename: D J
authors.initials: DJ
authors.lastname: Brinkman
authors.forename: J K
authors.initials: JK
authors.lastname: Bekema
authors.forename: M A
authors.initials: MA
authors.lastname: Kuijenhoven
authors.forename: J W
authors.initials: JW
authors.lastname: Wijnia
authors.forename: M J H J
authors.initials: MJ
authors.lastname: Dekker
authors.forename: M A
authors.initials: MA
authors.lastname: van Agtmael
mesh_terms: D000437:Alcoholism; D006801:Humans; D013831:Thiamine / Q000097:blood*; D013832:Thiamine Deficiency / Q000097:blood / Q000175:diagnosis*; D014899:Wernicke Encephalopathy / Q000097:blood / Q000175:diagnosis*
chemical_list: D013831:Thiamine