WHO 2012 Guidelines to treat Alcohol Withdrawal
- Clinicians should advise supported withdrawal in patients before beginning treatment.
- The World Health Organization recommends benzodiazepines as front-line medication for the management of alcohol withdrawal.
- Long-acting benzodiazepines are superior to shorter-acting ones, except in cases of impaired hepatic metabolism.
- Clinicians should determine the dose and duration individually.
- The duration of benzodiazepine treatment should be 3 to 7 days.
- Clinicians should not use antipsychotic medications as stand-alone medications for the management of alcohol withdrawal.
- Advise Benzodiazepines, and not anticonvulsants, following an alcohol withdrawal seizure.
- Clinicians should dispense psychoactive medication in small doses.
- Patients at risk of severe withdrawal, or who have concurrent serious physical or psychiatric disorders, or who lack adequate support, should preferably remain in an inpatient setting.
- As part of withdrawal management, we should give all patients oral thiamine.
- Patients at high risk of Wernicke's Encephalopathy (malnourished, severe withdrawal) should be given 3 days of parental thiamine.
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