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Successful treatment of severe alcohol withdrawal delirium with very high-dose diazepam (260–480 mg) administration

2024; Taylor & Francis; Volume: 40; Issue: 3 Linguagem: Inglês

10.1080/03007995.2024.2313687

1473-4877

Şükrü Alperen Korkmaz, Ebru Aldemir, Demet Güleç Öyekçin,

Neurological and metabolic disorders

Alcohol withdrawal delirium, commonly known as "delirium tremens (DT)", is the most severe clinical condition of alcohol withdrawal syndrome (AWS). Symptoms of DT include changes in consciousness and cognitive and perceptual impairments that fluctuate during the day. Treatment includes general support, such as helping the patient to re-orientate, close monitoring of vital signs and adequate hydration, and symptomatic treatment for agitation, autonomic instability, and hallucinations. In symptomatic treatment of DT, benzodiazepines are most commonly preferred due to their GABA-ergic effects. Diazepam, a benzodiazepine, has a faster onset of action than other benzodiazepines when administered intravenously (iv) and effectively controls symptoms. Although low doses of diazepam usually relieve DT symptoms, very high doses may be required in some patients. This case series discusses patients receiving high doses of diazepam to relieve DT symptoms.