Alcohol withdrawal: Outpatient management - Revision history

Rossdonaldson1: Changed redirect target from Alcohol withdrawal to Ethanol withdrawal

2025-07-30T22:10:51Z

Changed redirect target from Alcohol withdrawal to Ethanol withdrawal

← Older revision		Revision as of 22:10, 30 July 2025
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	#REDIRECT[[~~Alcohol~~ withdrawal]]		#REDIRECT [[Ethanol withdrawal]]

Rossdonaldson1: Redirected page to Alcohol withdrawal

2016-03-23T15:41:26Z

Redirected page to Alcohol withdrawal

← Older revision		Revision as of 15:41, 23 March 2016
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	~~=Background=~~		#REDIRECT[[Alcohol withdrawal]]
	*Consider discharge [[~~EBQ:Outpatient use of benzodiazepines for the treatment of acute alcohol withdrawl\|with 3 day course of benzodiazepines if patients are attempting to quit alcohol]]~~
	*Possible exclusions for outpatient treatment<ref>Myrick et al. A DOUBLE BLIND TRIAL OF GABAPENTIN VS. LORAZEPAM IN THE TREATMENT OF ALCOHOL WITHDRAWAL. Alcohol ~~Clin Exp Res. 2009 Sep; 33(9): 1582–1588. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769515/</ref>:~~
	**Substance use disorders except alcohol, nicotine, or cannabis
	**Major Axis I psych disorder
	**Medication hx of benzodiazepines, BBs, CCBs, antipsychotics
	**Hx of head injury, epilepsy, medical instability, ECG abnormality, grossly abnormal lab value

	~~==Management==~~
	~~===[[Chlordiazepoxide]]===~~
	~~'''Generally for outpatient treatment of mild cases and as a taper'''~~
	*25-50mg of chlordiazepoxide is equivalent to 10mg of diazepam
	*50mg of chlordiazepoxide every 8 hours for two days, thel decrease to 25mg every 8 hours for another two days followed by 25mg PRN as needed.

	~~===Anticonvulsants===~~
	*[[Gabapentin]] 400mg PO TID<ref>Leung JG, Hall-Flavin D, Nelson S, et al. The role of gabapentin in the management of alcohol withdrawal ~~and dependence. Ann Pharmacother. 2015; 49(8):897-906.</ref>~~
	**Some protocols call for higher dosing - 600 or 800mg x1
	*Similar efficacy to lorazepam in decreasing craving and anxiety<ref>Myrick, H et al. A double-blind trial of gabapentin versus lorazepam in the treatment of alcohol withdrawal. Alcohol Clin Exp Res. 2009 Sep;33(9):1582-8. PMID: 19485969</ref>

	*Example regimens (please use discretion and balance risk/benefits with your own clinical judgment)
	~~====Example outpatient [[lorazepam]] taper====~~
	*2 mg tid x3 days
	*2 mg bid on day 4
	*2 mg once on day 5

	~~====Example outpatient [[gabapentin]] taper====~~
	''Similar in efficacy to lorazepam according to one RCT<ref>Myrick et al. A DOUBLE BLIND TRIAL OF GABAPENTIN VS. LORAZEPAM IN THE TREATMENT OF ALCOHOL WITHDRAWAL. Alcohol Clin Exp Res. 2009 Sep; 33(9): 1582–1588. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769515/</ref>''
	*400 mg tid x3 days
	*300 mg bid on day 4
	*300 mg once on day 5

	~~==See Also==~~
	*[[Beer Potomania Syndrome]]
	*[[Alcohol (ETOH) Intoxication]]
	*[[Alcoholic ketoacidosis]]
	*[[Alcohol withdrawal]]
	*[[Alcohol withdrawal: Inpatient management]]
	*[[Alcohol withdrawal: Outpatient management]]
	*[[Alcohol withdrawal seizures]]
	*[[Altered mental status]]
	*[[Delerium tremens]]
	*[[EBQ:Outpatient use of benzodiazepines for the treatment of acute alcohol withdrawal]]
	*[[Sedative/Hypnotic]]
	*[[Wernicke-Korsakoff Syndrome]]

	~~==External Links==~~
	*[http://www.mdcalc.com/ciwa-ar-for-alcohol-withdrawal/#about-calculator MDCalc - CIWA-AR Calculator]

	~~==References==~~
	~~<references/>~~

	~~[[Category:Psychiatry]][[Category:Toxicology~~]]

Ostermayer: Text replacement - "Category:Tox" to "Category:Toxicology"

2016-03-22T16:23:39Z

Text replacement - "Category:Tox" to "Category:Toxicology"

← Older revision		Revision as of 16:23, 22 March 2016
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	<references/>		<references/>

	[[Category:Psychiatry]][[Category:~~Tox~~]]		[[Category:Psychiatry]][[Category:Toxicology]]

Ostermayer: Text replacement - "Category:Psych" to "Category:Psychiatry"

2016-03-22T16:02:59Z

Text replacement - "Category:Psych" to "Category:Psychiatry"

← Older revision		Revision as of 16:02, 22 March 2016
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	<references/>		<references/>

	[[Category:~~Psych~~]][[Category:Tox]]		[[Category:Psychiatry]][[Category:Tox]]

3amrbadawy at 17:53, 15 February 2016

2016-02-15T17:53:34Z

← Older revision		Revision as of 17:53, 15 February 2016
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	<references/>		<references/>

	[[Category:~~Tox~~]][[Category:~~Psych~~]]		[[Category:Psych]][[Category:Tox]]

3amrbadawy at 17:52, 15 February 2016

2016-02-15T17:52:46Z

← Older revision		Revision as of 17:52, 15 February 2016
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			=Background=
			*Consider discharge [[EBQ:Outpatient use of benzodiazepines for the treatment of acute alcohol withdrawl\|with 3 day course of benzodiazepines if patients are attempting to quit alcohol]]
			*Possible exclusions for outpatient treatment<ref>Myrick et al. A DOUBLE BLIND TRIAL OF GABAPENTIN VS. LORAZEPAM IN THE TREATMENT OF ALCOHOL WITHDRAWAL. Alcohol Clin Exp Res. 2009 Sep; 33(9): 1582–1588. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769515/</ref>:
			**Substance use disorders except alcohol, nicotine, or cannabis
			**Major Axis I psych disorder
			**Medication hx of benzodiazepines, BBs, CCBs, antipsychotics
			**Hx of head injury, epilepsy, medical instability, ECG abnormality, grossly abnormal lab value

	==Management==		==Management==
	===[[Chlordiazepoxide]]===		===[[Chlordiazepoxide]]===
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	*Similar efficacy to lorazepam in decreasing craving and anxiety<ref>Myrick, H et al. A double-blind trial of gabapentin versus lorazepam in the treatment of alcohol withdrawal. Alcohol Clin Exp Res. 2009 Sep;33(9):1582-8. PMID: 19485969</ref>		*Similar efficacy to lorazepam in decreasing craving and anxiety<ref>Myrick, H et al. A double-blind trial of gabapentin versus lorazepam in the treatment of alcohol withdrawal. Alcohol Clin Exp Res. 2009 Sep;33(9):1582-8. PMID: 19485969</ref>

			*Example regimens (please use discretion and balance risk/benefits with your own clinical judgment)
	====Example outpatient [[lorazepam]] taper====		====Example outpatient [[lorazepam]] taper====
	*2 mg tid x3 days		*2 mg tid x3 days

3amrbadawy at 17:51, 15 February 2016

2016-02-15T17:51:24Z

← Older revision		Revision as of 17:51, 15 February 2016
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	==External Links==		==External Links==
			*[http://www.mdcalc.com/ciwa-ar-for-alcohol-withdrawal/#about-calculator MDCalc - CIWA-AR Calculator]

	==References==		==References==
	<references/>		<references/>

			[[Category:Tox]][[Category:Psych]]

3amrbadawy at 17:46, 15 February 2016

2016-02-15T17:46:13Z

@@ Line 9: / Line 9: @@
 **Some protocols call for higher dosing - 600 or 800mg x1
 *Similar efficacy to lorazepam in decreasing craving and anxiety<ref>Myrick, H et al. A double-blind trial of gabapentin versus lorazepam in the treatment of alcohol withdrawal. Alcohol Clin Exp Res. 2009 Sep;33(9):1582-8.  PMID: 19485969</ref>
 ==See Also==

3amrbadawy at 17:40, 15 February 2016

2016-02-15T17:40:42Z

← Older revision		Revision as of 17:40, 15 February 2016
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	==See Also==		==See Also==
			*[[Beer Potomania Syndrome]]
			*[[Alcohol (ETOH) Intoxication]]
			*[[Alcoholic ketoacidosis]]
	*[[Alcohol withdrawal]]		*[[Alcohol withdrawal]]
			*[[Alcohol withdrawal: Inpatient management]]
			*[[Alcohol withdrawal: Outpatient management]]
	*[[Alcohol withdrawal seizures]]		*[[Alcohol withdrawal seizures]]
	*[[~~Alcohol withdrawal: Inpatient management~~]]		*[[Altered mental status]]
	*[[Delerium tremens]]		*[[Delerium tremens]]
			*[[EBQ:Outpatient use of benzodiazepines for the treatment of acute alcohol withdrawal]]
			*[[Sedative/Hypnotic]]
			*[[Wernicke-Korsakoff Syndrome]]

	==External Links==		==External Links==

3amrbadawy at 17:25, 15 February 2016

2016-02-15T17:25:14Z

← Older revision		Revision as of 17:25, 15 February 2016
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	==See Also==		==See Also==
			*[[Alcohol withdrawal]]
			*[[Alcohol withdrawal seizures]]
			*[[Alcohol withdrawal: Inpatient management]]
			*[[Delerium tremens]]

	==External Links==		==External Links==