Alcohol withdrawal syndrome: diagnostic and therapeutic methods

Interdisciplinary Study Group CRARL - SITAC - SIPaD - SITD - SIPDip, Giovanni Laviola, Simone Macri, Rosanna Mancinelli

Research output: Contribution to journalReview articlepeer-review


Alcohol withdrawal syndrome (AWS) is a medical emergency, rare in the general population, but very common among alcoholic individuals, which can lead to severe complications when unrecognized or late treated. It represents a clinical condition which can evolve in few hours or days following an abrupt cessation or reduction of alcohol intake and is characterized by hyperactivity of the autonomic nervous system resulting in the development of typical symptoms. According to DSM-5 criteria, the alcohol withdrawal syndrome is defined as such: if patients present at least two of typical signs and symptoms. The Clinical Institute Withdrawal Assessment of Alcohol Scale, revised version (CIWA-Ar), is the tool for assessing the severity of AWS. The support to patient with AWS includes pharmacological intervention as well as general support, restoration of biochemical imbalances and specific therapy. Regarding the pharmacological treatment, benzodiazepines represent the gold standard, in particular long-acting benzodiazepines, administered with a gradual reduction up to cessation.

Original languageEnglish
Pages (from-to)118-122
Number of pages5
JournalRivista di Psichiatria
Issue number3
Publication statusPublished - Jun 19 2018


  • Alcohol Withdrawal Delirium/diagnosis
  • Alcohol Withdrawal Seizures/drug therapy
  • Alcoholism/blood
  • Anticonvulsants/therapeutic use
  • Antipsychotic Agents/adverse effects
  • Autonomic Nervous System/physiopathology
  • Benzodiazepines/administration & dosage
  • Combined Modality Therapy
  • Counseling
  • Delayed Diagnosis
  • Drug Therapy, Combination
  • Emergencies
  • Ethanol/adverse effects
  • Humans
  • Kindling, Neurologic
  • Palliative Care
  • Severity of Illness Index
  • Symptom Assessment
  • Thiamine/therapeutic use


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