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 should be done
preferably 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, ALL THAT weeks during the first
month and spaced according to 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.
After ten days the withdrawal must
be total if one should consider that this is an outpatient weaning failure.
Author: Mohammad
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