Assessment of Pharmacological Treatment Quality: Comparison of Symptom-triggered vs. Fixed-schedule Alcohol Withdrawal in Clinical Practice

Pharmacopsychiatry. 2016 Sep;49(5):199-203. doi: 10.1055/s-0042-104508. Epub 2016 Apr 21.


Introduction: Despite the fact, that symptom-triggered alcohol withdrawal treatment is recommended by German guidelines on alcoholism, many hospitals continue to use fixed-schedule protocols, as they have been successfully applied for many years. Methods: This retrospective study compared all patients' records of alcohol withdrawal treatment from October 2010 to November 2011 at Magdeburg's University Department of Psychiatry (n=120). A symptom-triggered protocol with clomethiazole (AESB, n=46) was used in parallel with the existing fixed-schedule protocol with diazepam (n=74). Results: The symptom-triggered group showed less need of pharmacological treatment duration (p<0.001) and cumulative dosage of medication compared to the fixed-schedule protocol (p<0.006). No difference was observed regarding the need of clonidine or haloperidol (to treat blood pressure derailment or delirium) and the incidence of epileptic seizures. Discussion: Based on the shorter treatment duration and a similar rate of complications our department has switched to the symptom-triggered protocol to improve the quality of patient care.

MeSH terms

  • Adult
  • Alcohol-Induced Disorders / drug therapy*
  • Alcohol-Induced Disorders / prevention & control*
  • Chlormethiazole / therapeutic use*
  • Diazepam / therapeutic use*
  • Drug Administration Schedule
  • Female
  • GABA Modulators / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Retrospective Studies


  • GABA Modulators
  • Chlormethiazole
  • Diazepam