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Alcohol Withdrawal Syndrome
Published in Charles Theisler, Adjuvant Medical Care, 2023
Alcohol withdrawal is commonly encountered in general hospital settings. Alcohol withdrawal syndrome is a set of symptoms that occur in a predictable pattern following the last drink after a period of excessive use. Symptoms typically include anxiety, shakiness, headache, sweating, vomiting, rapid heart rate, confusion, and a mild fever. Tremors (shakes) usually begin within 5–10 hours after the last alcohol drink and typically peak at 24–48 hours. The most dangerous form of alcohol withdrawal is delirium tremens. Treating alcohol withdrawal is a short-term fix that does not help the core problem. Chronic alcoholism is the seventh leading risk factor for death and disability-adjusted life-years.1
Neurofeedback in Combination with Psychotherapy
Published in Hanno W. Kirk, Restoring the Brain, 2020
People with anxiety disorders are up to three times more likely to suffer an alcohol or other substance abuse disorder than those without an anxiety disorder. Studies have shown that problem drinking is more prevalent in patients with anxiety disorders. Because the suffering with these disorders is substantial, anxiety disorders should not go untreated. An additional problem is that long-term alcohol abuse usually means building a tolerance to its effects. This results in increased alcohol consumption to get the desired result. Therefore, what begins as a way to cope with anxiety can quickly have the opposite effect of increasing anxiety. Problem drinking leads to alcohol withdrawal, known as a “hangover.” The symptoms of alcohol withdrawal include anxiety and panic attacks, besides other possible symptoms such as agitation, nausea, vomiting, elevated blood pressure, elevated heart rate, and increased body temperature. These symptoms tend to create a cycle of heightened anxiety and increased problem drinking.42,43,44
Prescribing 2
Published in Kerry Layne, Albert Ferro, Janice Rymer, 100 Cases in Clinical Pharmacology, Therapeutics and Prescribing, 2020
Benzodiazepines should be prescribed to manage acute alcohol withdrawal. Chlordiazepoxide is typically the benzodiazepine of choice as it has a relatively low potential for abuse. This is prescribed orally. Patients with impaired liver function should be treated with either a reduced dose of chlordiazepoxide or lorazepam. Intravenous diazepam or lorazepam may be indicated if urgent control is required. This patient does not have significantly impaired liver function, as indicated by his normal liver function tests and INR result. The dose and frequency of benzodiazepines required is usually determined using an objective withdrawal scoring system, such as the ‘Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)’, to identify signs of withdrawal, such as tremor.
Cytokine level in patients with mood disorder, alcohol use disorder and their comorbidity
Published in The World Journal of Biological Psychiatry, 2023
Irina A. Mednova, Lyudmila A. Levchuk, Anastasiia S. Boiko, Olga V. Roschina, German G. Simutkin, Nikolay A. Bokhan, Anton J. M. Loonen, Svetlana A. Ivanova
Patients with MD (n = 43), participants with AUD-MD (n = 44) and AUD without MD (n = 42), were recruited from the departments of affective and addictive states of Mental Health Research Institute of the Tomsk National Research Medical Centre. Inclusion criteria were: a diagnosis of AUD (F10.2), MD (F31, F32, F33, F34.1) according to ICD-10 (World Health Organization 2004), or their comorbidity; ages 18–60 years. We excluded patients with other comorbid mental disorders, for instance schizophrenia, intellectual disability, and alcoholic psychoses, and patients with acute physical diseases. All participants had not taken any psychopharmacological drugs within 6 months prior to admission. The screening for relevant pathology for in/exclusion of subjects, disease development and the severity of the condition was performed through clinical assessment by three trained psychiatrists (O.R., G.S., and N.B.) on the first day of admission. Patients in the state of alcohol withdrawal received benzodiazepine therapy to alleviate withdrawal symptoms. The duration of alcohol withdrawal as estimated by the treating psychiatrists was on average 2–4 days after admission. The control group consisted of 50 healthy volunteers recruited through local advertisements at the MHRI and Siberian State Medical University. Healthy individuals were screened using a self-report questionnaire. The questionnaire screens for both physical and mental pathology, e.g. endocrine, neurological, gynaecological and psychiatric disorders.
Emergency department presentations of patients with alcohol use disorders in an Australian regional health district
Published in Substance Abuse, 2022
Jingxiang Zhang, Siyu Qian, Guoxin Su, Chao Deng, David Reid, Kate Curtis, Barbara Sinclair, Ping Yu
This study found that patients who did not have any interaction with the community-based D&A services were older, more likely to present with abdominal pain and chest pain, less likely to be diagnosed with alcohol use disorders and more likely to stay in EDs for more than four hours. As alcohol withdrawal and complications may occur six hours after the last drink,24 these patients might experience unexpected acute alcohol withdrawal if alcohol use disorders were not identified early in the presentation. Routine alcohol screening in EDs may assist in early identification in this patient group and minimization of harms to these patients. Further research is needed to investigate if these patients were referred to the hospital-based D&A CL service for specialized treatment as required by local guidelines.25,26
Alcohol and melatonin
Published in Chronobiology International, 2021
Alcohol withdrawal syndrome and exacerbation of related somatic diseases are among the most frequent alcohol pathologies. Alcohol withdrawal is the basis of alcoholic pathology and provides the most reliable evidence of the physical dependence on ethanol, reflecting many regularities and characteristics of its manifestations. The aversion of acute withdrawal symptoms and drunkenness is one of the main goals of the management of alcohol dependence, as treatment begins with the elimination of such symptoms. The objectives of acute alcohol stress (AAS) treatment are alleviation of the patient’s subjective experiences and prevention of severe withdrawal symptoms, such as delirium, seizures, acute alcoholic hallucinosis, cardiac complications, etc. Adequate treatment of AAS and post-abstinence syndrome largely determines the subsequent course of the disease, as in this stage it is important to prevent an early relapse (Marlatt and Witkiewitz 2005). However, medications used to treat AAS have a number of limitations. For example, benzodiazepine-group medications, currently considered the most effective ones for the treatment of withdrawal syndrome, quite often have adverse effects and lead to drug dependence (Lejoyeux et al. 1998).