Pharmacological Treatment of Alcohol Withdrawal

Detalhes bibliográficos
Autor(a) principal: Teixeira, Joana
Data de Publicação: 2022
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15799
Resumo: Introduction: Excessive chronic alcohol users, and particularly patients with alcohol use disorder, may present an alcohol withdrawal syndrome if they abruptly stop drinking. Alcohol withdrawal syndrome requires pharmacological treatment for the treatment of withdrawal symptoms and to prevent withdrawal complications. Medically assisted withdrawal treatment is used in alcohol treatment units, but it is also frequently required in patients admitted to hospital for other conditions.Methods: Review of major guidelines covering treatment of withdrawal syndrome with the aim to describe recent evidence and recommendations about the pharmacological treatment for alcohol withdrawal syndrome.Results: Four major guidelines concerning treatment of withdrawal syndrome were selected (National Institute for Health and Care Excellence, American Society of Addiction Medicine, World Federation of Societies of Biological Psychiatry and American Psychiatric Association) and screened for the recommendations and level of evidence on drug prescribing for alcohol withdrawal syndrome. The Maudsley guidelines were also considered in this review.Discussion: All the four reviewed guidelines recommended benzodiazepines as the first line treatment for alcohol withdrawal syndrome. The association of anticonvulsivants, adrenergic alpha-2 agonists, betablockers and antipsychotics with benzodiazepines is recommended for symptom reduction in severe alcohol withdrawal syndrome. Thiamine should be administered to all patients to prevent Wernicke-Korsakoff encephalopathy. If there is any electrolytic imbalance it should be corrected.Conclusion: Maintaining a high level of suspicion for alcohol withdrawal syndrome is important across all clinical settings, and it should be promptly treated.
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spelling Pharmacological Treatment of Alcohol WithdrawalTratamento Farmacológico da Síndrome de Abstinência AlcoólicaAlcohol AbstinenceAlcoholism/drug therapySubstance Withdrawal SyndromeAbstinência de ÁlcoolAlcoolismo/tratamento farmacológicoSíndrome de AbstinênciaIntroduction: Excessive chronic alcohol users, and particularly patients with alcohol use disorder, may present an alcohol withdrawal syndrome if they abruptly stop drinking. Alcohol withdrawal syndrome requires pharmacological treatment for the treatment of withdrawal symptoms and to prevent withdrawal complications. Medically assisted withdrawal treatment is used in alcohol treatment units, but it is also frequently required in patients admitted to hospital for other conditions.Methods: Review of major guidelines covering treatment of withdrawal syndrome with the aim to describe recent evidence and recommendations about the pharmacological treatment for alcohol withdrawal syndrome.Results: Four major guidelines concerning treatment of withdrawal syndrome were selected (National Institute for Health and Care Excellence, American Society of Addiction Medicine, World Federation of Societies of Biological Psychiatry and American Psychiatric Association) and screened for the recommendations and level of evidence on drug prescribing for alcohol withdrawal syndrome. The Maudsley guidelines were also considered in this review.Discussion: All the four reviewed guidelines recommended benzodiazepines as the first line treatment for alcohol withdrawal syndrome. The association of anticonvulsivants, adrenergic alpha-2 agonists, betablockers and antipsychotics with benzodiazepines is recommended for symptom reduction in severe alcohol withdrawal syndrome. Thiamine should be administered to all patients to prevent Wernicke-Korsakoff encephalopathy. If there is any electrolytic imbalance it should be corrected.Conclusion: Maintaining a high level of suspicion for alcohol withdrawal syndrome is important across all clinical settings, and it should be promptly treated.Introdução: Quando os consumidores excessivos crónicos de álcool, particularmente os indivíduos com o diagnóstico de perturbação de uso de álcool, suspendem abruptamente o consumo de bebidas alcoólicas, pode surgir um quadro clínico denominado síndrome de abstinência alcoólica. Nestes casos, é necessário muitas vezes instituir tratamento farmacológico para aliviar os sintomas e prevenir as complicações da abstinência. O tratamento farmacológico da síndrome de abstinência alcoólica é utilizado em unidades especializadas no tratamento de perturbação de uso de álcool, mas também pode ser necessário em serviços médico-cirúrgicos, quando esta síndrome se manifesta em doentes com perturbação de uso de álcool internados por patologias orgânicas.Métodos: Revisão de guidelines disponíveis na literatura sobre tratamento da síndrome de abstinência alcoólica com o objetivo de determinar qual o tratamento farmacológico recomendado.Resultados: Foram analisadas as quatro guidelines sobre tratamento farmacológico da síndrome de abstinência alcoólica (National Institute for Health and Care Excellence, American Society of Addiction Medicine, World Federation of Societies of Biological Psychiatry e American Psychiatric Association), em relação às suas recomendações e evidência da eficácia dos fármacos para tratamento da síndrome de abstinência alcoólica. Esta análise foi ainda complementada pela consulta das guidelines de Maudsley.Discussão: As guidelines analisadas recomendam, como tratamento de primeira linha, o uso de benzodiazepinas. A associação de anticonvulsivantes, agonistas adrenérgicos alfa-2, betabloqueantes e antipsicóticos com benzodiazepinas está recomendada para controlo sintomático em quadros de privação mais exuberantes. É recomendado administrar tiamina para profilaxia da encefalopatia de Wernicke-Korsakoff a todos os doentes. Caso existam desequilíbrios hidroelectrolíticos, estes deverão ser corrigidos.Conclusão: É fundamental manter um nível elevado de suspeita para o eventual aparecimento da síndrome de abstinência alcoólica em todos os contextos clínicos. Nesses casos, importa saber intervir precocemente.Ordem dos Médicos2022-04-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15799oai:ojs.www.actamedicaportuguesa.com:article/15799Acta Médica Portuguesa; Vol. 35 No. 4 (2022): April; 286-293Acta Médica Portuguesa; Vol. 35 N.º 4 (2022): Abril; 286-2931646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15799https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15799/6390https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15799/6391Direitos de Autor (c) 2021 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessTeixeira, Joana2022-12-20T11:07:38Zoai:ojs.www.actamedicaportuguesa.com:article/15799Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:40.783588Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Pharmacological Treatment of Alcohol Withdrawal
Tratamento Farmacológico da Síndrome de Abstinência Alcoólica
title Pharmacological Treatment of Alcohol Withdrawal
spellingShingle Pharmacological Treatment of Alcohol Withdrawal
Teixeira, Joana
Alcohol Abstinence
Alcoholism/drug therapy
Substance Withdrawal Syndrome
Abstinência de Álcool
Alcoolismo/tratamento farmacológico
Síndrome de Abstinência
title_short Pharmacological Treatment of Alcohol Withdrawal
title_full Pharmacological Treatment of Alcohol Withdrawal
title_fullStr Pharmacological Treatment of Alcohol Withdrawal
title_full_unstemmed Pharmacological Treatment of Alcohol Withdrawal
title_sort Pharmacological Treatment of Alcohol Withdrawal
author Teixeira, Joana
author_facet Teixeira, Joana
author_role author
dc.contributor.author.fl_str_mv Teixeira, Joana
dc.subject.por.fl_str_mv Alcohol Abstinence
Alcoholism/drug therapy
Substance Withdrawal Syndrome
Abstinência de Álcool
Alcoolismo/tratamento farmacológico
Síndrome de Abstinência
topic Alcohol Abstinence
Alcoholism/drug therapy
Substance Withdrawal Syndrome
Abstinência de Álcool
Alcoolismo/tratamento farmacológico
Síndrome de Abstinência
description Introduction: Excessive chronic alcohol users, and particularly patients with alcohol use disorder, may present an alcohol withdrawal syndrome if they abruptly stop drinking. Alcohol withdrawal syndrome requires pharmacological treatment for the treatment of withdrawal symptoms and to prevent withdrawal complications. Medically assisted withdrawal treatment is used in alcohol treatment units, but it is also frequently required in patients admitted to hospital for other conditions.Methods: Review of major guidelines covering treatment of withdrawal syndrome with the aim to describe recent evidence and recommendations about the pharmacological treatment for alcohol withdrawal syndrome.Results: Four major guidelines concerning treatment of withdrawal syndrome were selected (National Institute for Health and Care Excellence, American Society of Addiction Medicine, World Federation of Societies of Biological Psychiatry and American Psychiatric Association) and screened for the recommendations and level of evidence on drug prescribing for alcohol withdrawal syndrome. The Maudsley guidelines were also considered in this review.Discussion: All the four reviewed guidelines recommended benzodiazepines as the first line treatment for alcohol withdrawal syndrome. The association of anticonvulsivants, adrenergic alpha-2 agonists, betablockers and antipsychotics with benzodiazepines is recommended for symptom reduction in severe alcohol withdrawal syndrome. Thiamine should be administered to all patients to prevent Wernicke-Korsakoff encephalopathy. If there is any electrolytic imbalance it should be corrected.Conclusion: Maintaining a high level of suspicion for alcohol withdrawal syndrome is important across all clinical settings, and it should be promptly treated.
publishDate 2022
dc.date.none.fl_str_mv 2022-04-01
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dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15799/6390
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/15799/6391
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2021 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2021 Acta Médica Portuguesa
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 35 No. 4 (2022): April; 286-293
Acta Médica Portuguesa; Vol. 35 N.º 4 (2022): Abril; 286-293
1646-0758
0870-399X
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