An Experimental Study of the Etiology of “Rum Fits” and Delirium Tremens

Isbell, Harris; Fraser, H. F.; Wikler, Abraham; Belleville, Richard E.; Eisenman, Anna J.

doi:10.15288/qjsa.1955.16.001

Cited by 476 publications

(58 citation statements)

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“…The concept of a self-limiting burst of seizures after drug discontinuation arose from observations of patients with no prior history of epilepsy who had seizures on discontinuation of alcohol or other sedative drugs (Pohlisch, 1928;Kalinowsky, 1942;Isbell et al, 1950Isbell et al, , 1955Hollister et al, 1%1;Giove and Gastaut, 1965;Victor and Brausch, 1967;Marks, 1983;Chan, 1985). Whether patients whose epilepsy is in remission may have a self-limiting burst of withdrawal seizures on discontinuation of AED therapy or whether seizures at this time indicate a continuing long-term need for AED treatment (Chadwick, 1985) is uncertain.…”

Section: The Question Of Withdrawal Seizuresmentioning

confidence: 99%

“…Withdrawal seizures in patients with no prior history of epilepsy usually take the form of generalized convulsions (Pohlisch, 1928;Kalinowsky, 1942;Isbell et al, 1950Isbell et al, , 1955Alexander, 1951;Hollister et al, 1961;Victor and Brausch, 1%7;Deisenhammer et al, 1984;Chan, 1985), although partial seizures are well recognized in patients with cerebral lesions and/or a previous history of partial seizures (Giove and Gastaut, 1%5; Victor and Brausch, 1%7;Malcolm, 1972;Earnest and Yarnell, 1976;Deisenhammer et al, 1984). In investigations of highly selected patients, usually with a single EEG focus, AED reductions have generally precipitated patients' habitual seizures; although there have been reports that atypical seizures may occur (Spencer et al, 1981;Engel and Crandall, 1983;Marciani and Gotman, 1986).…”

Section: The Question Of Withdrawal Seizuresmentioning

confidence: 99%

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Discontinuation of Phenytoin, Carbamazepine, and Valproate in Patients with Active Epilepsy

1990

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The effects of discontinuing individual antiepileptic drugs (AEDs) in patients with active epilepsy who are receiving combination therapy have not been studied systematically. We report a double-blind, prospective study of discontinuation of phenytoin (PHT), carbamazepine (CBZ), and valproate (VPA) in 70 patients with chronic active epilepsy. Each drug discontinuation was randomized to one of two relatively fast rates of reduction, and a control group of 25 patients continued with stable therapy. Patients who had CBZ removed had a significant increase in seizures that was maintained for 4 weeks after the end of drug reduction, and 10 of these 23 patients had to restart therapy with CBZ. There was no significant change in seizure numbers in the other groups. Two patients discontinued from VPA had to restart the drug; none had to restart PHT. The optimal rates of reduction of CBZ remain uncertain. There was no evidence for a clinically or temporally distinct burst of "discontinuation seizures" in any group. Any marked increase in seizures always resolved on reintroduction of the discontinued drug.

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Section: The Question Of Withdrawal Seizuresmentioning

confidence: 99%

Section: The Question Of Withdrawal Seizuresmentioning

confidence: 99%

Discontinuation of Phenytoin, Carbamazepine, and Valproate in Patients with Active Epilepsy

1990

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“…Such figures obviously depend critically on the criteria for admission and the definition of alcohol withdrawal. If seizures occur after alcohol withdrawal they commonly do so at 24-48 hours (Kalinowsky, 1942;Isbell et al, 1955;Giove and Gastaut, 1965;Hillbom and Hjelm-Jager, 1984). In a study of 241 patients with alcohol withdrawal seizures, in 50 per cent the onset of seizures was between 13 and 24 hours after drinking stopped, and in 90 per cent the onset was between 7 and 48 hours (Victor and Brausch, 1967).…”

Section: Alcohol Withdrawal Seizuresmentioning

confidence: 99%

“…The type of seizure occurring on alcohol withdrawal is usually a generalized convulsion (Kalinowsky, 1942;Isbell et al, 1955;Victor and Brausch, 1967;Deisenhammer et al, 1984;Chan, 1985). Focal seizures occurred in 12 of 241 cases studied by Victor and Brausch (1967).…”

Section: Alcohol Withdrawal Seizuresmentioning

confidence: 99%

Neuropsychiatric aspects of sedative drug withdrawal

Duncan

1988

Human Psychopharmacology

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The withdrawal syndromes after discontinuance of alcohol, barbiturates, benzodiazepines and other sedative drugs, such as chloral and paraldehyde, are all similar. The severity of a withdrawal reaction is largely determined by the daily dose, the duration of administration and the rate of fall of the drug levels after withdrawal, as well as the propensity of the individual patient. The time course of a withdrawal reaction is determined by the drug's clearance. Alcohol has a half‐life of a few hours; withdrawal symptoms may develop within 6–8 hours of abstinence and convulsions in 12–48 hours. After discontinuance of short‐ or medium‐acting barbiturates (half‐life 8–40 hours) symptoms may develop in 1–3 days, followed by convulsions and delirium after 3–8 days. Symptoms and seizures may develop in the 1–10 days after withdrawal of benezodiazepines. In patients with no prior history of epilepsy the types of seizures most commonly induced by drug withdrawal are generalized convulsions, but partial seizures are not uncommon if there is a focal cerebral lesion, or a previous history of partial seizures. Paroxysmal activity and photosensitivity may occur after barbiturate withdrawal in non‐epileptics, more commonly in severe withdrawal reactions. Similar EEG changes may be seen after alcohol and benzodiazepine withdrawal, but photosensitivity does not appear to have been shown to be a feature of the benzodiazepine withdrawal syndrome.

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“…Equally serious are those complications of long term alcohol consumption that are often encountered in psychiatric practice. Thus hallucinations, paranoid delusions, delirium tremens, and convulsions are not infrequently encountered, often after withdrawal from alcohol (Isbell et al, 1955;Johnson, 1961;MendelM)n et al, 1964). Many of these consequences of alcohol use are life endangering and the most appropriate treatment is that provided by the medical services.…”

Section: Alcoholism As a Disease: An Assertionmentioning

confidence: 99%

Alcoholism and the Concept of Disease

Hershon¹

1974

British Journal of Addiction to Alcohol & Other Drugs

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An Experimental Study of the Etiology of “Rum Fits” and Delirium Tremens

Cited by 476 publications

References 0 publications

Discontinuation of Phenytoin, Carbamazepine, and Valproate in Patients with Active Epilepsy

Discontinuation of Phenytoin, Carbamazepine, and Valproate in Patients with Active Epilepsy

Neuropsychiatric aspects of sedative drug withdrawal

Alcoholism and the Concept of Disease

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