Management of alcohol withdrawal syndrome: A systematic review
Abstract
A clinical condition known as Alcohol Withdrawal Syndrome (AWS) develops in people with chronic alcohol use disorder (AUD) when their alcohol consumption is reduced or stopped. From minor discomfort to serious, life-threatening complications like seizures and delirium tremens, the syndrome can present with a wide range of symptoms. AWS's pathophysiology, clinical manifestations, diagnostic techniques, management approaches, and prevention are all intended to be thoroughly covered in this review. It also looks at new developments in therapy and how tailored care can help patients get better results.
Keywords:
Alcohol use disorder (AUD), etiology, epidemiology, management, disorder
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References
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26. Kattimani S, Bharadwaj B. Clinical management of alcohol withdrawal: A systematic review. Ind Psychiatry J. 2013 Jul;22(2):100-8.
2. de Wit M, Jones DG, Sessler CN, Zilberberg MD, Weaver MF. Alcohol-use disorders in the critically ill patient. Chest. 2010 Oct 1;138(4):994-1003.
3. Perry EC. Inpatient management of acute alcohol withdrawal syndrome. CNS drugs. 2014 May;28(5):401-10.
4. Mennecier D, Thomas M, Arvers P, Corberand D, Sinayoko L, Bonnefoy S, Harnois F, Thiolet C. Factors predictive of complicated or severe alcohol withdrawal in alcohol dependent inpatients. Gastroentérologiecliniqueetbiologique. 2008 Aug 1;32(8-9):792-7.
5. Chan GM, Hoffman RS, Gold JA, Whiteman PJ, Goldfrank LR, Nelson LS. Racial variations in the incidence of severe alcohol withdrawal. Journal of Medical Toxicology. 2009 Mar;5:8-14.
6. Verhulst B, Neale MC, Kendler KS. The heritability of alcohol use disorders: a meta-analysis of twin and adoption studies. Psychological medicine. 2015 Apr;45(5):1061-72.
7. Witkiewitz K, Litten RZ, Leggio L. Advances in the science and treatment of alcohol use disorder. Sci Adv. 2019 Sep;5(9):eaax4043.
8. Goodson CM, Clark BJ, Douglas IS. Predictors of severe alcohol withdrawal syndrome: a systematic review and meta-analysis. Alcohol ClinExp Res. 2014 Oct;38(10):2664-77.
9. Steel TL, Malte CA, Bradley KA, Lokhandwala S, Hough CL, Hawkins EJ. Prevalence and Variation of Clinically Recognized Inpatient Alcohol Withdrawal Syndrome in the Veterans Health Administration. J Addict Med. 2020 Jul/Aug;14(4):300-304.
10. Leach JP, Mohanraj R, Borland W. Alcohol and drugs in epilepsy: pathophysiology, presentation, possibilities, and prevention. Epilepsia. 2012; 53(Suppl 4): 48–57.
11. Cosgrove KP, Krantzler E, Frohlich EB, et al. Dopamine and serotonin transporter availability during acute alcohol withdrawal: effects of comorbid tobacco smoking. Neuropsychopharmacology. 2009; 34: 2218–2226
12. Zakhari S. Overview: how is alcohol metabolized by the body? Alcohol Res Health. 2006;29(4):245-54.
13. Mainerova B, Prasko J, Latalova K, Axmann K, Cerna M, Horacek R, Bradacova R. Alcohol withdrawal delirium-diagnosis, course and treatment. Biomedical Papers of the Medical Faculty of Palacky University in Olomouc. 2015 Mar 1;159(1).
14. Kattimani S, Bharadwaj B. Clinical management of alcohol withdrawal: A systematic review. Ind Psychiatry J. 2013; 22: 100–108.
15. Driessen M, Lange W, Junghanns K, Wetterling T. Proposal of a comprehensive clinical typology of alcohol withdrawal–a cluster analysis approach. Alcohol Alcohol. 2005; 40: 308–313.
16. Schuckit MA. Recognition and management of withdrawal delirium (delirium tremens). New England Journal of Medicine. 2014 Nov 27;371(22):2109-13.
17. https://my.clevelandclinic.org/health/diseases/alcohol-withdrawal
18. Kessel KM, Olson LM, Kruse DA, Lyden ER, Whiston KE, Blodgett MM, Balasanova AA. Phenobarbital Versus Benzodiazepines for the Treatment of Severe Alcohol Withdrawal. Ann Pharmacother. 2024 Sep;58(9):877-885
19. Calabrese J, Brown J, Hasan M, Neuhut S, Jo Y. Hospital Readmission in Alcohol Use Disorder Patients: The Role of Anti-Craving Medications and Discharge Disposition. HCA Healthc J Med. 2022;3(2):39-45.
20. Hammond DA, Rowe JM, Wong A, Wiley TL, Lee KC, Kane-Gill SL. Patient Outcomes Associated With Phenobarbital Use With or Without Benzodiazepines for Alcohol Withdrawal Syndrome: A Systematic Review. Hosp Pharm. 2017 Oct;52(9):607-616.
21. Palmer BF, Clegg DJ. Electrolyte Disturbances in Patients with Chronic Alcohol-Use Disorder. N Engl J Med. 2017 Oct 05;377(14):1368-1377.
22. Gottlieb M, Chien N, Long B. Managing Alcohol Withdrawal Syndrome. Ann Emerg Med. 2024 Jul;84(1):29-39. doi: 10.1016/j.annemergmed.2024.02.016. Epub 2024 Mar 25. PMID: 38530674.
23. Mayo-Smith MF. Pharmacological management of alcohol withdrawal: a meta-analysis and evidence-based practice guideline. Jama. 1997 Jul 9;278(2):144-51.
24. https://emedicine.medscape.com/article/819502-treatment?form=fpf
25. National Institute for Health and Care Excellence. NICE CG100; 2017 [Internet] [cited 2022 Dec 6]. Available from:
26. Kattimani S, Bharadwaj B. Clinical management of alcohol withdrawal: A systematic review. Ind Psychiatry J. 2013 Jul;22(2):100-8.
Published
22/02/2025
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How to Cite
Singh, A. P., and A. P. Singh. “Management of Alcohol Withdrawal Syndrome: A Systematic Review”. International Journal of Health Care and Biological Sciences, Vol. 6, no. 1, Feb. 2025, pp. 10-14, doi:10.46795/ijhcbs.v6i1.665.
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Review Articles
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