The Treatment of Alcohol Withdrawal

Guthrie, Sally K.

doi:10.1002/j.1875-9114.1989.tb04119.x

Cited by 58 publications

(12 citation statements)

References 98 publications

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“…The experimental rats were fed a Lieber-DeCarli liquid diet (Dyets Inc., Bethlehem, PA, USA; Lieber & DeCarli, 1982, 1989 containing ethanol (ED; 6.5% ethanol). Control (CD) rats were pair-fed (i.e.…”

Section: Alcohol Consumption Protocolsmentioning

confidence: 99%

Ethanol withdrawal induces hyperalgesia mediated by PKCε

Dina

Messing

Levine

2006

Eur J of Neuroscience

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Symptoms of ethanol withdrawal include heightened responses to sensory stimuli, as well as tremors and convulsions. We tested the hypothesis that repeated episodes of ethanol intake and withdrawal exacerbate the symptoms of alcohol-induced peripheral neuropathy. In contrast to the hyperalgesia produced when an alcohol (6.5%)-containing diet was fed continuously to male rats which took 4 weeks to develop (Dina et al., 2000), feeding alcohol (6.5%) in repeated cycles of 4 days of alcohol followed by 3 days without alcohol resulted in a withdrawal-induced hyperalgesia that began at the end of one weekly cycle and reached a maximum during the fourth cycle. For ethanol withdrawal to produce hyperalgesia, ethanol consumption needed to be terminated for a period of 2 days. Paradoxically, as the amount of alcohol consumed decreased, the hyperalgesia induced by withdrawal developed more rapidly, being maximal between 1.4 and 1.6% ethanol. These results suggest that continued exposure to ethanol also has a neuroprotective effect. Withdrawal-induced hyperalgesia, similar to the hyperalgesia induced by continuous, chronic alcohol intake, was inhibited reversibly by intrathecal administration of an antisense oligodeoxynucleotide to protein kinase C (PKC)epsilon.

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Section: Alcohol Consumption Protocolsmentioning

confidence: 99%

Ethanol withdrawal induces hyperalgesia mediated by PKCε

Dina

Messing

Levine

2006

Eur J of Neuroscience

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“…3 Strategies used in such cases include use of higher doses or using combinations of diazepam, lorazepam, midazolam, phenobarbitone, fentanyl, and propofol. 4 Probable causes for the patient's development of sudden high grade fever as well as requirement of higher than standard doses of benzodiazepines were evaluated. 5 Patients with DT get frequently physically restrained due to causes like disruption of therapy, confusion and prevention of falls.…”

Section: Discussionmentioning

confidence: 99%

The dilemma of using physical restraint in delirium tremens: a case report

2019

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Delirium tremens (DT) is a common presentation in tertiary care hospitals. Refractory DT, though not very common, is a dreaded presentation in any clinical setting. Usually, patients with DT respond to standard doses of benzodiazepines, but sometimes we encounter patients requiring higher than the usual dose. Also, due to the high level of agitation, confusion and hallucinatory behaviour, physical restraint is frequently used in these patients. We hereby report a case of refractory DT in whom the dilemma of using physical restraint and need for higher doses of Benzodiazepine has been highlighted.

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“…Delirium tremens usually lasts for 5-7 days, with onset between 48-72 hours after the last drink in patients with alcohol dependence. (3) The duration of delirium tremens can be prolonged if there are underlying medical causes such as infections, electrolyte abnormalities or pneumonia. (4) In our patient, rhabdomyolysis, which was diagnosed and resolved quickly, may have contributed to the delirium.…”

Section: Discussionmentioning

confidence: 99%

A case of prolonged delirium tremens

Nicholas¹,

Jacob²,

Kinson³

2013

smedj

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C a s e R e p o r t e152 I NTRO D U C TIO NDelirium tremens, the most serious manifestation of alcohol withdrawal, occurs in approximately 5% of hospitalised patients with alcohol dependence and has a reported mortality rate approaching 15%.(1) The current diagnostic criteria for delirium tremens include disturbance of consciousness, change in cognition or perceptual disturbance developing in a short period, and emergence of symptoms during or shortly after withdrawal from heavy alcohol intake. Delirium tremens usually lasts for approximately 5-7 days, and prolonged delirium tremens is rare, usually occurring only if there are underlying medical causes. There are only a few cases of prolonged delirium tremens treated with high-dose benzodiazepines described in the literature.(2) Herein, we report the case of a patient with prolonged delirium tremens that lasted for 35 days, requiring high-dose benzodiazepines. The patient's delirium tremens resolved with no major underlying medical complicating factors. ABSTRACT We present a case of delirium tremens lasting for five weeks in an alcohol-dependent individual. The patient required high-dose benzodiazepines, which is atypical and rare. The clinical presentation and management of this patient is discussed. CA S E R EPO RT

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The Treatment of Alcohol Withdrawal

Cited by 58 publications

References 98 publications

Ethanol withdrawal induces hyperalgesia mediated by PKCε

Ethanol withdrawal induces hyperalgesia mediated by PKCε

The dilemma of using physical restraint in delirium tremens: a case report

A case of prolonged delirium tremens

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