0
0

Sections

Excerpt

Alcohol and sedative-hypnotic withdrawal can result in a frank delirium that is life-threatening (Marco and Kelen 1990; Olmedo and Hoffman 2000). The acute signs of early alcohol, sedative-hypnotic, and benzodiazepine withdrawal are similar and include autonomic instability, tremulousness, diaphoresis, and gastrointestinal disturbances. Autonomic signs include tachycardia, hypertension, and hyperthermia. Treatment of this withdrawal state is best accomplished with a long-half-life benzodiazepine. Use of long-half-life agents such as diazepam or chlordiazepoxide prevents peaks and troughs in blood levels, thereby leading to a smoother taper. During the first 24 hours, vital signs should be taken at 2- to 4-hour intervals and additional benzodiazepine given if vital signs are still elevated. After 24 hours, the total dose should be added up and given as four divided doses, which are then decreased 10%–20% per day. In patients with significant liver disease, lorazepam or oxazepam should be used in preference to other benzodiazepines because their metabolism is not as dependent on hepatic function. It is important to consider concomitant medications, since -blockers prescribed for a general medical condition may mask the autonomic signs of withdrawal.

Your session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Related Content
Articles
Books
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 7.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 8.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 12.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 25.  >
Psychiatric News
 
  • Print
  • PDF
  • E-mail
  • Chapter Alerts
  • Get Citation