Alcohol withdrawal

High consumption of alcohol causes after a few years a kind of tolerance that can be compared to that of other central nervous system depressants such as benzodiazepines, opioids, hypnotics.

The patient increases the amount of alcohol to achieve the same effects and, therefore, occurs DEPENDENCE (see this term).

If the patient stops abruptly consumption there is a withdrawal syndrome that is characterized by tremors, sweating, hypertension, tachycardia, insomnia, anxiety.

Sometimes can manifest a more severe syndrome:

Epilepsy withdrawal that occurs after many years of abuse, and is characterized by seizures occurring on average 24 hours after weaning.

This may precede delirium tremens (see this term).

Alcoholic hallucinosis which appears after a period of massive and prolonged high consumption.

The patient is experiencing auditory hallucinations especially, is terrified.

It may also precede delirium tremens (see this term)

TREATMENT

Weaning is difficult and must be done in a specialized, usually in a psychiatric hospital by competent teams and used to treat these patients.

To be successful weaning it is essential that the patient is determined to do, and is cooperating.

It is essential to recognize his alcoholism and agrees to be helped.

The use of benzodiazepines can relieve anxiety of these patients especially early weaning.

Acamprosate helps with a strong presence of psychological help prevent relapse after weaning

It is possible to envisage an outpatient withdrawal at home, especially if the environment interacts with the attending physician and if the patient is really motivated.

A companion work in a state of trust is essential.

The withdrawal method is not suitable for single subjects, fragile face significant pressures in particular professional.

The treatment is to use a benzodiazepine doses during the first 48 hours, then decreasing doses to achieve the stop after 5 to 6 days.

A beta-blocker may be attached for ten days.

B group vitamins are beneficial.

All treatment will be stopped after ten days.

A work stoppage of a few days may be prescribed if necessary.

After the first three weeks of abstinence will be useful to prescribe acamprosate for several weeks to avoid appetite.

Doctor's consultation will be made three times the first week, twice the second, weekly during the first month and then spaced at the success of weaning.

In some cases the alcohol will be total and immediate abolition but in other cases it will be possible to gradually reduce the consumption of alcohol in ten days.