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Alcohol withdrawal

MedGen UID:
536543
•Concept ID:
C0236663
•
Disease or Syndrome
Synonyms: alcohol withdrawal; Alcohol withdrawal syndrome; alcohol withdrawal syndrome
SNOMED CT: Alcohol withdrawal syndrome (191480000); Alcohol withdrawal (191480000)
 
Monarch Initiative: MONDO:0005433

Definition

Processes and symptomatic effects resulting from abstinence from alcohol. Used for both human and animal populations. [from PSY]

Professional guidelines

PubMed

Clinical management of the alcohol withdrawal syndrome.
Day E, Daly C
Addiction 2022 Mar;117(3):804-814. Epub 2021 Aug 22 doi: 10.1111/add.15647. PMID: 34288186
Alcohol withdrawal syndrome management: Is there anything new?
Airagnes G, Ducoutumany G, Laffy-Beaufils B, Le Faou AL, Limosin F
Rev Med Interne 2019 Jun;40(6):373-379. Epub 2019 Mar 7 doi: 10.1016/j.revmed.2019.02.001. PMID: 30853380
ACG Clinical Guideline: Alcoholic Liver Disease.
Singal AK, Bataller R, Ahn J, Kamath PS, Shah VH
Am J Gastroenterol 2018 Feb;113(2):175-194. Epub 2018 Jan 16 doi: 10.1038/ajg.2017.469. PMID: 29336434Free PMC Article

Recent clinical studies

Etiology

Use of Phenobarbital in Alcohol Withdrawal Management - A Retrospective Comparison Study of Phenobarbital and Benzodiazepines for Acute Alcohol Withdrawal Management in General Medical Patients.
Nisavic M, Nejad SH, Isenberg BM, Bajwa EK, Currier P, Wallace PM, Velmahos G, Wilens T
Psychosomatics 2019 Sep-Oct;60(5):458-467. Epub 2019 Feb 14 doi: 10.1016/j.psym.2019.02.002. PMID: 30876654
Alcohol withdrawal syndrome management: Is there anything new?
Airagnes G, Ducoutumany G, Laffy-Beaufils B, Le Faou AL, Limosin F
Rev Med Interne 2019 Jun;40(6):373-379. Epub 2019 Mar 7 doi: 10.1016/j.revmed.2019.02.001. PMID: 30853380
Alcohol withdrawal syndrome: diagnostic and therapeutic methods.
Attilia F, Perciballi R, Rotondo C, Capriglione I, Iannuzzi S, Attilia ML, Coriale G, Vitali M, Cereatti F, Fiore M, Ceccanti M; Interdisciplinary Study Group CRARL - SITAC - SIPaD - SITD - SIPDip
Riv Psichiatr 2018 May-Jun;53(3):118-122. doi: 10.1708/2925.29413. PMID: 29912213
Management of Acute Alcohol Withdrawal Syndrome in Critically Ill Patients.
Dixit D, Endicott J, Burry L, Ramos L, Yeung SY, Devabhakthuni S, Chan C, Tobia A, Bulloch MN
Pharmacotherapy 2016 Jul;36(7):797-822. Epub 2016 Jun 30 doi: 10.1002/phar.1770. PMID: 27196747
Phenobarbital for acute alcohol withdrawal: a prospective randomized double-blind placebo-controlled study.
Rosenson J, Clements C, Simon B, Vieaux J, Graffman S, Vahidnia F, Cisse B, Lam J, Alter H
J Emerg Med 2013 Mar;44(3):592-598.e2. Epub 2012 Sep 19 doi: 10.1016/j.jemermed.2012.07.056. PMID: 22999778

Diagnosis

Alcohol withdrawal syndrome: diagnostic and therapeutic methods.
Attilia F, Perciballi R, Rotondo C, Capriglione I, Iannuzzi S, Attilia ML, Coriale G, Vitali M, Cereatti F, Fiore M, Ceccanti M; Interdisciplinary Study Group CRARL - SITAC - SIPaD - SITD - SIPDip
Riv Psichiatr 2018 May-Jun;53(3):118-122. doi: 10.1708/2925.29413. PMID: 29912213
Alcohol withdrawal syndrome: mechanisms, manifestations, and management.
Jesse S, Bråthen G, Ferrara M, Keindl M, Ben-Menachem E, Tanasescu R, Brodtkorb E, Hillbom M, Leone MA, Ludolph AC
Acta Neurol Scand 2017 Jan;135(1):4-16. Epub 2016 Sep 1 doi: 10.1111/ane.12671. PMID: 27586815Free PMC Article
Identification and management of alcohol withdrawal syndrome.
Mirijello A, D'Angelo C, Ferrulli A, Vassallo G, Antonelli M, Caputo F, Leggio L, Gasbarrini A, Addolorato G
Drugs 2015 Mar;75(4):353-65. doi: 10.1007/s40265-015-0358-1. PMID: 25666543Free PMC Article
Recognition and management of withdrawal delirium (delirium tremens).
Schuckit MA
N Engl J Med 2014 Nov 27;371(22):2109-13. doi: 10.1056/NEJMra1407298. PMID: 25427113
Alcohol-use disorders.
Schuckit MA
Lancet 2009 Feb 7;373(9662):492-501. Epub 2009 Jan 23 doi: 10.1016/S0140-6736(09)60009-X. PMID: 19168210

Therapy

Comparative efficacy and safety of pharmacotherapies for alcohol withdrawal: a systematic review and network meta-analysis.
Bahji A, Bach P, Danilewitz M, Crockford D, El-Guebaly N, Devoe DJ, Saitz R
Addiction 2022 Oct;117(10):2591-2601. Epub 2022 Mar 15 doi: 10.1111/add.15853. PMID: 35194860Free PMC Article
Clinical management of the alcohol withdrawal syndrome.
Day E, Daly C
Addiction 2022 Mar;117(3):804-814. Epub 2021 Aug 22 doi: 10.1111/add.15647. PMID: 34288186
Novel Algorithms for the Prophylaxis and Management of Alcohol Withdrawal Syndromes-Beyond Benzodiazepines.
Maldonado JR
Crit Care Clin 2017 Jul;33(3):559-599. doi: 10.1016/j.ccc.2017.03.012. PMID: 28601135
Recognition and management of withdrawal delirium (delirium tremens).
Schuckit MA
N Engl J Med 2014 Nov 27;371(22):2109-13. doi: 10.1056/NEJMra1407298. PMID: 25427113
Phenobarbital for acute alcohol withdrawal: a prospective randomized double-blind placebo-controlled study.
Rosenson J, Clements C, Simon B, Vieaux J, Graffman S, Vahidnia F, Cisse B, Lam J, Alter H
J Emerg Med 2013 Mar;44(3):592-598.e2. Epub 2012 Sep 19 doi: 10.1016/j.jemermed.2012.07.056. PMID: 22999778

Prognosis

Evaluation of the course and treatment of Alcohol Withdrawal Syndrome with the Clinical Institute Withdrawal Assessment for Alcohol - Revised: A systematic review-based meta-analysis.
Pribék IK, Kovács I, Kádár BK, Kovács CS, Richman MJ, Janka Z, Andó B, Lázár BA
Drug Alcohol Depend 2021 Mar 1;220:108536. Epub 2021 Jan 19 doi: 10.1016/j.drugalcdep.2021.108536. PMID: 33503582
Alcohol Withdrawal Syndrome in Neurocritical Care Unit: Assessment and Treatment Challenges.
Farrokh S, Roels C, Owusu KA, Nelson SE, Cook AM
Neurocrit Care 2021 Apr;34(2):593-607. Epub 2020 Aug 13 doi: 10.1007/s12028-020-01061-8. PMID: 32794143
Will This Hospitalized Patient Develop Severe Alcohol Withdrawal Syndrome?: The Rational Clinical Examination Systematic Review.
Wood E, Albarqouni L, Tkachuk S, Green CJ, Ahamad K, Nolan S, McLean M, Klimas J
JAMA 2018 Aug 28;320(8):825-833. doi: 10.1001/jama.2018.10574. PMID: 30167704Free PMC Article
ACG Clinical Guideline: Alcoholic Liver Disease.
Singal AK, Bataller R, Ahn J, Kamath PS, Shah VH
Am J Gastroenterol 2018 Feb;113(2):175-194. Epub 2018 Jan 16 doi: 10.1038/ajg.2017.469. PMID: 29336434Free PMC Article
The "Prediction of Alcohol Withdrawal Severity Scale" (PAWSS): systematic literature review and pilot study of a new scale for the prediction of complicated alcohol withdrawal syndrome.
Maldonado JR, Sher Y, Ashouri JF, Hills-Evans K, Swendsen H, Lolak S, Miller AC
Alcohol 2014 Jun;48(4):375-90. Epub 2014 Feb 19 doi: 10.1016/j.alcohol.2014.01.004. PMID: 24657098

Clinical prediction guides

Mast-cell-specific receptor mediates alcohol-withdrawal-associated headache in male mice.
Son H, Zhang Y, Shannonhouse J, Ishida H, Gomez R, Kim YS
Neuron 2024 Jan 3;112(1):113-123.e4. Epub 2023 Oct 30 doi: 10.1016/j.neuron.2023.09.039. PMID: 37909038Free PMC Article
Beyond benzodiazepines: a meta-analysis and narrative synthesis of the efficacy and safety of alternative options for alcohol withdrawal syndrome management.
Fluyau D, Kailasam VK, Pierre CG
Eur J Clin Pharmacol 2023 Sep;79(9):1147-1157. Epub 2023 Jun 28 doi: 10.1007/s00228-023-03523-2. PMID: 37380897
Phenobarbital versus benzodiazepines in alcohol withdrawal syndrome.
Malone D, Costin BN, MacElroy D, Al-Hegelan M, Thompson J, Bronshteyn Y
Neuropsychopharmacol Rep 2023 Dec;43(4):532-541. Epub 2023 Jun 27 doi: 10.1002/npr2.12347. PMID: 37368937Free PMC Article
Comparative efficacy and safety of pharmacotherapies for alcohol withdrawal: a systematic review and network meta-analysis.
Bahji A, Bach P, Danilewitz M, Crockford D, El-Guebaly N, Devoe DJ, Saitz R
Addiction 2022 Oct;117(10):2591-2601. Epub 2022 Mar 15 doi: 10.1111/add.15853. PMID: 35194860Free PMC Article
Alcohol Withdrawal Syndrome in Neurocritical Care Unit: Assessment and Treatment Challenges.
Farrokh S, Roels C, Owusu KA, Nelson SE, Cook AM
Neurocrit Care 2021 Apr;34(2):593-607. Epub 2020 Aug 13 doi: 10.1007/s12028-020-01061-8. PMID: 32794143

Recent systematic reviews

Phenobarbital treatment of alcohol withdrawal in the emergency department: A systematic review and meta-analysis.
Lee CM, Dillon DG, Tahir PM, Murphy CE 4th
Acad Emerg Med 2024 May;31(5):515-524. Epub 2024 Jan 8 doi: 10.1111/acem.14825. PMID: 37923363Free PMC Article
Buprenorphine versus methadone for the treatment of opioid dependence: a systematic review and meta-analysis of randomised and observational studies.
Degenhardt L, Clark B, Macpherson G, Leppan O, Nielsen S, Zahra E, Larance B, Kimber J, Martino-Burke D, Hickman M, Farrell M
Lancet Psychiatry 2023 Jun;10(6):386-402. Epub 2023 May 8 doi: 10.1016/S2215-0366(23)00095-0. PMID: 37167985
Comparative efficacy and safety of pharmacotherapies for alcohol withdrawal: a systematic review and network meta-analysis.
Bahji A, Bach P, Danilewitz M, Crockford D, El-Guebaly N, Devoe DJ, Saitz R
Addiction 2022 Oct;117(10):2591-2601. Epub 2022 Mar 15 doi: 10.1111/add.15853. PMID: 35194860Free PMC Article
Will This Hospitalized Patient Develop Severe Alcohol Withdrawal Syndrome?: The Rational Clinical Examination Systematic Review.
Wood E, Albarqouni L, Tkachuk S, Green CJ, Ahamad K, Nolan S, McLean M, Klimas J
JAMA 2018 Aug 28;320(8):825-833. doi: 10.1001/jama.2018.10574. PMID: 30167704Free PMC Article
The "Prediction of Alcohol Withdrawal Severity Scale" (PAWSS): systematic literature review and pilot study of a new scale for the prediction of complicated alcohol withdrawal syndrome.
Maldonado JR, Sher Y, Ashouri JF, Hills-Evans K, Swendsen H, Lolak S, Miller AC
Alcohol 2014 Jun;48(4):375-90. Epub 2014 Feb 19 doi: 10.1016/j.alcohol.2014.01.004. PMID: 24657098

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