Original ArticleSymptom-Triggered Therapy for Alcohol Withdrawal Syndrome in Medical Inpatients
Section snippets
Patients
We retrospectively identified inpatients at Saint Marys Hospital treated for AWS from January 1, 1995, through December 31, 1998, by 2 methods. Hospital discharge diagnoses during the study period were reviewed for alcoholism, alcohol withdrawal, delirium tremens, and alcohol withdrawal seizures. In addition, hospital pharmacy data were reviewed to identify patients who received thiamine and benzodiazepines simultaneously during a given admission for the same period of time. Patients who did
Patient and Alcohol Withdrawal Treatment Characteristics
Of 638 admissions found (536 patients), 216 met the inclusion criteria for this study (Table 2). The patient and alcohol withdrawal treatment characteristics are summarized by admission treatment group in Table 3, Table 4. There were 63 male admissions (75.0%) for AWS in the preimplementation cohort, and 95 (72.0%) were postimplementation admissions. The average (SD) age at admission was 55.4 (15.5) years vs 51.8 (13.7) years in the 2 cohorts. The median length of hospitalization was 3 days for
DISCUSSION
Benzodiazepines provide effective treatment for alcohol withdrawal symptoms and also decrease the risk of seizures and delirium tremens in placebo-controlled studies.1 Symptom-triggered therapy produces equivalent reduction in symptoms compared with fixed-schedule benzodiazepine treatment in chemical dependency unit patients.6 However, little data exist to demonstrate the superiority of symptom-triggered therapy for treating the symptoms and complications of AWS over traditional strategies of
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Evaluation of the course and treatment of Alcohol Withdrawal Syndrome with the Clinical Institute Withdrawal Assessment for Alcohol – Revised: A systematic review-based meta-analysis
2021, Drug and Alcohol DependenceCitation Excerpt :The amount of received doses gradually decrease over time; also, the fixed-dose regimen may be modified according to withdrawal symptom severity, in case the predetermined fixed-dose would prove to be inadequate in controlling withdrawal symptoms (Wong et al., 2020). Previous scientific works have demonstrated that symptom-triggered therapy, which is a CIWA-Ar-based regimen, showed better effectiveness compared to fixed-schedule therapy (Cassidy et al., 2012; Daeppen et al., 2002; Ismail et al., 2019; Jaeger et al., 2001; Reoux and Miller, 2000; Sachdeva et al., 2014). Benzodiazepines (BZDs) such as diazepam, lorazepam, chlordiazepoxide or oxazepam are predominantly regarded as symptom-triggered therapies and are first choices in the treatment of AWS (Weintraub, 2017).
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