Treatment of Alcohol Withdrawal Syndrome
If you have mild to moderate withdrawal symptoms, your doctor may prefer to treat you in an outpatient setting, especially if you have supportive family and friends. Outpatient detoxification is safe, effective, and less costly than inpatient detoxification at a hospital or other facility.
However, you may require inpatient treatment if you don't have a reliable social network, are pregnant, or have a history of any of the following:
- Severe withdrawal symptoms
- Withdrawal seizures or DTs
- Multiple previous detoxifications
- Certain medical or psychiatric illnesses
The goals of treatment are threefold: reducing immediate withdrawal symptoms, preventing complications, and beginning long-term therapy to promote alcohol abstinence.
Prescription drugs of choice include benzodiazepines, such as diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan), and oxazepam (Serax). Such medications can help control the shakiness, anxiety, and confusion associated with alcohol withdrawal and reduce the risk of withdrawal seizures and DTs. In patients with mild to moderate symptoms, the anticonvulsant drug carbamazepine (Tegretol) may be an effective alternative to benzodiazepines, because it is not sedating and has low potential for abuse.
To help manage withdrawal complications, your doctor may consider adding other drugs to a benzodiazepine regimen. These may include:
- An antipsychotic drug, which can help relieve agitation and hallucinations
- A beta-blocker, which may help curb a fast heart rate and elevated blood pressure related to withdrawal and reduce the strain of alcohol withdrawal in people with coronary artery disease
Clonidine (Catapres), another blood pressure drug
- Phenytoin (Dilantin), an anticonvulsant which doesn't treat withdrawal seizures but may be useful in people with an underlying seizure disorder
Preventing Future Alcohol Withdrawal Episodes
Because successful treatment of alcohol withdrawal syndrome doesn't address the underlying disease of addiction, it should be followed by treatment for alcohol abuse or alcohol dependence.
Relatively brief outpatient interventions can be effective for alcohol abuse, but more intensive therapy may be required for alcohol dependence. If you have alcohol dependence, your doctor may prescribe other medications to help you stop drinking. He or she also may recommend joining a 12-step group -- such as Alcoholics Anonymous and Narcotics Anonymous -- or staying at a comprehensive treatment facility that offers a combination of a 12-step model, cognitive-behavioral therapy, and family therapy.