Identification and management of alcohol withdrawal syndrome

Antonio Mirijello, Cristina D'Angelo, Anna Ferrulli, Gabriele Vassallo, Mariangela Antonelli, Fabio Caputo, Lorenzo Leggio, Antonio Gasbarrini, Giovanni Addolorato

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)353-365
Number of pages13
JournalDrugs
Volume75
Issue number4
DOIs
Publication statusPublished - 2015

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Medicine(all)

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    Mirijello, A., D'Angelo, C., Ferrulli, A., Vassallo, G., Antonelli, M., Caputo, F., Leggio, L., Gasbarrini, A., & Addolorato, G. (2015). Identification and management of alcohol withdrawal syndrome. Drugs, 75(4), 353-365. https://doi.org/10.1007/s40265-015-0358-1