Friday, 8 January 2021

WHO 2012 Guidelines for the Treatment of Alcohol Withdrawal

WHO 2012 Guidelines to treat Alcohol Withdrawal

  1. Clinicians should advise supported withdrawal in patients before beginning treatment.
  2. The World Health Organization recommends benzodiazepines as front-line medication for the management of alcohol withdrawal. 
  3. Long-acting benzodiazepines are superior to shorter-acting ones, except in cases of impaired hepatic metabolism. 
  4. Clinicians should determine the dose and duration individually. 
  5. The duration of benzodiazepine treatment should be 3 to 7 days.
  6. Clinicians should not use antipsychotic medications as stand-alone medications for the management of alcohol withdrawal. 
  7. Advise Benzodiazepines, and not anticonvulsants, following an alcohol withdrawal seizure.
  8. Clinicians should dispense psychoactive medication in small doses.  
  9. 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. 
  10. As part of withdrawal management, we should give all patients oral thiamine. 
  11. Patients at high risk of Wernicke's Encephalopathy (malnourished, severe withdrawal) should be given 3 days of parental thiamine. 

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