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August 17, 1994

Refining the Treatment of Alcohol Withdrawal

Author Affiliations

From the National Institute on Alcohol Abuse and Alcoholism, Rockville, Md.

JAMA. 1994;272(7):557-558. doi:10.1001/jama.1994.03520070077042

An important advance of the past quarter century has been the use of benzodiazepines to treat alcohol withdrawal. The life-threatening consequence of alcohol withdrawal, delirium tremens, which formerly was a common cause for hospital admission, at least to public hospitals, is an uncommon occurrence today. The landmark multihospital controlled trial conducted by Kaim et al1 comparing chlordiazepoxide with placebo and three other drugs established the therapeutic efficacy of benzodiazepines for alcohol withdrawal. This fact is sometimes lost sight of as newer pharmacologic agents are introduced and evaluated for treatment of alcohol withdrawal. Because there are different drugs available to treat alcohol withdrawal, physicians may be confused as to which one and which dosage regimen should be used as first-line therapy.

See also p 519.

For example, clonidine is effective for treatment of alcohol withdrawal symptoms2 but is not recommended as first-line therapy because it does not prevent seizures.

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