Trends in the management of alcohol withdrawal syndrome

James P. Newman, David J Terris, Michelle Moore

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Alcohol use among head and neck cancer patients is common. Alcohol withdrawal (especially delirium tremens) poses significant potential morbidity to postsurgical patients. Treatment with newer benzodiazepines (BZDs) such as lorazepam and midazolam has become more widespread, and mortality rates from severe alcohol withdrawal have decreased in recent years. The authors retrospectively studied 102 patients with a diagnosis of alcohol withdrawal, including 20 patients undergoing surgery for cancer of the head and neck. There were 81 men and 21 women, with a mean (± standard deviation [SD]) age of 52.3 (± 16.1) years. Many of these patients (46%) were treated with more than one BZD or other neuroleptic, while 49% received single agent therapy of either chlordiazepoxide (26%) or lorazepam (23%). Delirium tremens occurred in 12% of all patients undergoing withdrawal and in 10% of head and neck cancer patients, with a mortality rate of 9% and 0%, respectively. Single agent use was successful in greater than 95% when either lorazepam or chlordiazepoxide was used. Instances of combination treatment where older BZDs were used yielded a 69% success rate. The higher complication rate and lower treatment success with combination treatment was multifactorial. Optimal management of the alcohol withdrawal syndrome requires an understanding of its patho-physiology and the principles of its prevention along with a familiarity of BZD pharmacokinetic drug profiles. The authors present a treatment plan which is cost-effective, keeps morbidity low, and should allow a continued decreasing trend in mortality rates from delirium tremens.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalLaryngoscope
Volume105
Issue number1
DOIs
StatePublished - Jan 1 1995

Fingerprint

Alcohol Withdrawal Delirium
Alcohols
Benzodiazepines
Lorazepam
Head and Neck Neoplasms
Chlordiazepoxide
Mortality
Therapeutics
Morbidity
Midazolam
Antipsychotic Agents
Pharmacokinetics
Costs and Cost Analysis
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Trends in the management of alcohol withdrawal syndrome. / Newman, James P.; Terris, David J; Moore, Michelle.

In: Laryngoscope, Vol. 105, No. 1, 01.01.1995, p. 1-7.

Research output: Contribution to journalArticle

Newman, James P. ; Terris, David J ; Moore, Michelle. / Trends in the management of alcohol withdrawal syndrome. In: Laryngoscope. 1995 ; Vol. 105, No. 1. pp. 1-7.
@article{850fbe7955e64b3fa14dafe1edcef20c,
title = "Trends in the management of alcohol withdrawal syndrome",
abstract = "Alcohol use among head and neck cancer patients is common. Alcohol withdrawal (especially delirium tremens) poses significant potential morbidity to postsurgical patients. Treatment with newer benzodiazepines (BZDs) such as lorazepam and midazolam has become more widespread, and mortality rates from severe alcohol withdrawal have decreased in recent years. The authors retrospectively studied 102 patients with a diagnosis of alcohol withdrawal, including 20 patients undergoing surgery for cancer of the head and neck. There were 81 men and 21 women, with a mean (± standard deviation [SD]) age of 52.3 (± 16.1) years. Many of these patients (46{\%}) were treated with more than one BZD or other neuroleptic, while 49{\%} received single agent therapy of either chlordiazepoxide (26{\%}) or lorazepam (23{\%}). Delirium tremens occurred in 12{\%} of all patients undergoing withdrawal and in 10{\%} of head and neck cancer patients, with a mortality rate of 9{\%} and 0{\%}, respectively. Single agent use was successful in greater than 95{\%} when either lorazepam or chlordiazepoxide was used. Instances of combination treatment where older BZDs were used yielded a 69{\%} success rate. The higher complication rate and lower treatment success with combination treatment was multifactorial. Optimal management of the alcohol withdrawal syndrome requires an understanding of its patho-physiology and the principles of its prevention along with a familiarity of BZD pharmacokinetic drug profiles. The authors present a treatment plan which is cost-effective, keeps morbidity low, and should allow a continued decreasing trend in mortality rates from delirium tremens.",
author = "Newman, {James P.} and Terris, {David J} and Michelle Moore",
year = "1995",
month = "1",
day = "1",
doi = "10.1288/00005537-199501000-00004",
language = "English (US)",
volume = "105",
pages = "1--7",
journal = "Laryngoscope",
issn = "0023-852X",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Trends in the management of alcohol withdrawal syndrome

AU - Newman, James P.

AU - Terris, David J

AU - Moore, Michelle

PY - 1995/1/1

Y1 - 1995/1/1

N2 - Alcohol use among head and neck cancer patients is common. Alcohol withdrawal (especially delirium tremens) poses significant potential morbidity to postsurgical patients. Treatment with newer benzodiazepines (BZDs) such as lorazepam and midazolam has become more widespread, and mortality rates from severe alcohol withdrawal have decreased in recent years. The authors retrospectively studied 102 patients with a diagnosis of alcohol withdrawal, including 20 patients undergoing surgery for cancer of the head and neck. There were 81 men and 21 women, with a mean (± standard deviation [SD]) age of 52.3 (± 16.1) years. Many of these patients (46%) were treated with more than one BZD or other neuroleptic, while 49% received single agent therapy of either chlordiazepoxide (26%) or lorazepam (23%). Delirium tremens occurred in 12% of all patients undergoing withdrawal and in 10% of head and neck cancer patients, with a mortality rate of 9% and 0%, respectively. Single agent use was successful in greater than 95% when either lorazepam or chlordiazepoxide was used. Instances of combination treatment where older BZDs were used yielded a 69% success rate. The higher complication rate and lower treatment success with combination treatment was multifactorial. Optimal management of the alcohol withdrawal syndrome requires an understanding of its patho-physiology and the principles of its prevention along with a familiarity of BZD pharmacokinetic drug profiles. The authors present a treatment plan which is cost-effective, keeps morbidity low, and should allow a continued decreasing trend in mortality rates from delirium tremens.

AB - Alcohol use among head and neck cancer patients is common. Alcohol withdrawal (especially delirium tremens) poses significant potential morbidity to postsurgical patients. Treatment with newer benzodiazepines (BZDs) such as lorazepam and midazolam has become more widespread, and mortality rates from severe alcohol withdrawal have decreased in recent years. The authors retrospectively studied 102 patients with a diagnosis of alcohol withdrawal, including 20 patients undergoing surgery for cancer of the head and neck. There were 81 men and 21 women, with a mean (± standard deviation [SD]) age of 52.3 (± 16.1) years. Many of these patients (46%) were treated with more than one BZD or other neuroleptic, while 49% received single agent therapy of either chlordiazepoxide (26%) or lorazepam (23%). Delirium tremens occurred in 12% of all patients undergoing withdrawal and in 10% of head and neck cancer patients, with a mortality rate of 9% and 0%, respectively. Single agent use was successful in greater than 95% when either lorazepam or chlordiazepoxide was used. Instances of combination treatment where older BZDs were used yielded a 69% success rate. The higher complication rate and lower treatment success with combination treatment was multifactorial. Optimal management of the alcohol withdrawal syndrome requires an understanding of its patho-physiology and the principles of its prevention along with a familiarity of BZD pharmacokinetic drug profiles. The authors present a treatment plan which is cost-effective, keeps morbidity low, and should allow a continued decreasing trend in mortality rates from delirium tremens.

UR - http://www.scopus.com/inward/record.url?scp=0028839954&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028839954&partnerID=8YFLogxK

U2 - 10.1288/00005537-199501000-00004

DO - 10.1288/00005537-199501000-00004

M3 - Article

C2 - 7837904

AN - SCOPUS:0028839954

VL - 105

SP - 1

EP - 7

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

IS - 1

ER -