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. 2015 Mar;75(4):353-65.
doi: 10.1007/s40265-015-0358-1.

Identification and Management of Alcohol Withdrawal Syndrome

Free PMC article

Identification and Management of Alcohol Withdrawal Syndrome

Antonio Mirijello et al. Drugs. .
Free PMC article


Symptoms of alcohol withdrawal syndrome (AWS) may develop within 6-24 h after the abrupt discontinuation or decrease of alcohol consumption. Symptoms can vary from autonomic hyperactivity and agitation to delirium tremens. The gold-standard treatment for AWS is with benzodiazepines (BZDs). Among the BZDs, different agents (i.e., long-acting or short-acting) and different regimens (front-loading, fixed-dose or symptom-triggered) may be chosen on the basis of patient characteristics. Severe withdrawal could require ICU admission and the use of barbiturates or propofol. Other drugs, such as α2-agonists (clonidine and dexmetedomidine) and β-blockers can be used as adjunctive treatments to control neuroautonomic hyperactivity. Furthermore, neuroleptic agents can help control hallucinations. Finally, other medications for the treatment for AWS have been investigated with promising results. These include carbamazepine, valproate, sodium oxybate, baclofen, gabapentin and topiramate. The usefulness of these agents are discussed.

Conflict of interest statement

Conflicts of Interest

Dr. Addolorato served as a consultant for Ortho-McNeil Janssen Scientific Affairs, LLC, and D&A Pharma, was paid for his consulting services and received lecture fees and grants from D&A Pharma, CT Laboratories and Lundbeck.

Dr. Caputo reports personal fees from D&A Pharma and personal fees from CT Pharmaceutical Industries.

Dr. Mirijello, Dr. D’Angelo, Dr. Ferrulli, Dr. Vassallo, Dr. Antonelli, Dr. Leggio and Dr. Gasbarrini report no financial interests or potential conflicts of interest.


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