.Drug of choice for alcohol withdrawal
Disulfiram
Chlormethazole
Chlordiazepoxide
Buspirone
Treatment of alcohol dependence comprises 2 steps namely detoxification and de addiction DETOXIFICATION Detoxification implies removal of the toxic substance from the body, this can be done by using a drug similar to alcohol and thus benzodiazepine is chosen. This is the main drug used in treatment of alcohol withdrawal despite the problem being simple withdrawal, rum fits or delirium tremens IF LIVER FUNCTION IS WITHIN NORMAL LIMITS CHOOSE CHLORDIAZEPOXIDE, AS IT HAS A SIMILAR STRUCTURAL FORMULA LIKE ALCOHOL IF LIVER FUNCTION IS ABNORMAL CHOOSE LORAZEPAM, AS IT DOES NOT WORSEN LIVER DERANGEMENTS FRONT LOADING=====patient is loaded with benzodiazepines SYMPTOM TRIGGER=== benzodiazepines is offered only as and when the withdrawal symptom arises FIXED DOSAGE====== regular fixed dosage of benzodiazepine is given in divided doses and slowly tapered so that the patient is not on any drugs by the end of 2 weeks Ref.Kaplon and Sadock, synopsis of psychiatry, 11 th edition, pf no.625
Substance abuse