Benzodiazepine for alcohol withdrawal syndrome
Benzodiazepines (BDZs) is the mainstay for alcohol withdrawal syndrome treatment. They reduce autonomic hyperactivity and may prevent seizures and/or delirium tremens. All BDZs are effective. Initial doses are higher than those used for treating anxiety. Symptom triggered dosing with repeated evaluation utilizing a standardized protocol (e.g. CIWA-Ar 1)) may be more efficacious than fixed-dose schedules 2)
Avoid IM administration (erratic absorption).
1)
Sullivan JT, Sykora K, Schneiderman J, et al. Assessment of Alcohol Withdrawal: The Revised Clinical Institute Withdrawal Assessment for Alcohol Scale (CIWA-Ar). Br J Addict. 1989; 84:1353–1357
2)
Saitz R, Mayo-Smith MF, Roberts MS, et al. Individualized Treatment for Alcohol Withdrawal: A Randomized Double-Blind Controlled Trial. JAMA. 1994; 272:519–523