Alcohol withdrawal is a common condition encountered in the hospital setting after abrupt discontinuation of alcohol in an alcohol-dependent individual. Patients may present with mild symptoms of tremulousness and agitation or more severe symptoms including withdrawal seizures and delirium tremens. Management revolves around early identification of at-risk individuals and symptom assessment using a validated tool such as the revised Clinical Institute Withdrawal Assessment for Alcohol score. Benzodiazepines remain the mainstay of treatment and can be administered using a front-loading, fixed-dose, or symptom-triggered approach. Long-acting benzodiazepines such as chlordiazepoxide or diazepam are commonly used and may provide a smoother withdrawal than shorter-acting benzodiazepines, but there are no data to support superiority of one benzodiazepine over another. Elderly patients or those with significant liver disease may have increased accumulation and decreased clearance of the long-acting benzodiazepines, and lorazepam or oxazepam may be preferred in these patients. Patients with symptoms refractory to high doses of benzodiazepines may require addition of a rescue medication such as phenobarbital, propofol or dexmedetomidine. Anticonvulsants (carbamazepine, valproate, gabapentin) may have a role in the management of mild to moderate withdrawal. Other medications such as β-antagonists or neuroleptics may offer additional benefit in select patients but should not be used a monotherapy. Inpatient Management of Acute Alcohol Withdrawal Syndrome | CNS Drugs | Springer Nature Link Skip to main content Advertisement Inpatient Management of Acute Alcohol Withdrawal Syndrome Therapy in Practice Published: 30 April 2014 Volume 28 , pages 401–410 ( 2014 ) Cite this article Save article View saved research CNS Drugs Aims and scope Submit manuscript Abstract Alcohol withdrawal is a common condition encountered in the hospital setting after abrupt discontinuation of alcohol in an alcohol-dependent individual. Patients may present with mild symptoms of tremulousness and agitation or more severe symptoms including withdrawal seizures and delirium tremens. Management revolves around early identification of at-risk individuals and symptom assessment using a validated tool such as the revised Clinical Institute Withdrawal Assessment for Alcohol score. Benzodiazepines remain the mainstay of treatment and can be administered using a front-loading, fixed-dose, or symptom-triggered approach. Long-acting benzodiazepines such as chlordiazepoxide or diazepam are commonly used and may provide a smoother withdrawal than shorter-acting benzodiazepines, but there are no data to support superiority of one benzodiazepine over another. Institutional subscriptions Similar content being viewed by others Diazepam in the Treatment of Moderate to Severe Alcohol Withdrawal Article 18 January 2017 Management of Alcohol Withdrawal Syndromes Chapter © 2017 Management of Alcohol Withdrawal Syndromes Chapter © 2020 Explore related subjects Discover the latest articles, books and news in related subjects, suggested using machine learning. Alcohol misuse in dental patients Alcoholic Liver Disease Alcoholism Drugs Psychopharmacology Substance Abuse Disorder Management of Alcohol Withdrawal Syndrome References Kosten TR, O’Connor PG. 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CNS Drugs 28 , 401–410 (2014). https://doi.org/10.1007/s40263-014-0163-5 Download citation Published : 30 April 2014 Issue date : May 2014 DOI : https://doi.org/10.1007/s40263-014-0163-5 Share this article Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy shareable link to clipboard Provided by the Springer Nature SharedIt content-sharing initiative Keywords GABAA Receptor Dexmedetomidine Withdrawal Symptom Alcohol Withdrawal Oxazepam Access this article Log in via an institution Subscribe and save Springer+ from €37.37 /Month Starting from 10 chapters or articles per month Access and download chapters and articles from more than 300k books and 2,500 journals Cancel anytime View plans Buy Now Buy article PDF 39,95 € Price includes VAT (Indonesia) Instant access to the full article PDF. Institutional subscriptions Advertisement