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January 18, 1995

Individualized Treatment of Alcohol Withdrawal-Reply

Author Affiliations

Boston City Hospital
Harvard Medical School Boston, Mass

JAMA. 1995;273(3):183-184. doi:10.1001/jama.1995.03520270017012

In Reply.  —One goal of our study was to follow up on the hypotheses generated in previous work that suggested that less medication could be used to treat alcohol withdrawal when therapy was individualized using an alcohol withdrawal severity measure. To accomplish this goal, we compared an individualized treatment strategy to a well-established, commonly used regimen. Our study showed that symptom-triggered therapy is more appropriate (shorter, less intense pharmacologic treatment and guided by the patient's symptoms) than fixed-schedule regimens for patients with alcohol dependence who abruptly cease their regular alcohol intake.Regarding generalizability, we would not extend our results to apply to those with seizures or acute coexistent illness. The alcohol withdrawal severity scales contain items that are not specific for alcohol withdrawal and that may be present for other reasons in patients with coexistent acute illness. Acute illness and seizures may also place patients at risk for more severe

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