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Alcohol Detoxification
In order to be included onto an Alcohol Abuse or Misuse Detoxification Programme, patients should have suffered at least some recognisable symptoms of alcohol sub-acute withdrawal, chronic abuse:
or acute alcohol withdrawal, including Delirium Tremens.
Assessment of liver function is essential. LFT, proteins, hepatic enzymes, cholesterol, LDL, HDL, vitamin K, tests will be performed.
Appropriate hydration, vitamin and mineral therapy will be first considered.
Appropriate hydration consists of the necessary fluids and electrolytes to balance dehydration.
Vitamin B complex, or Vitamin B1 (thiamine) 50mg twice daily, for three weeks, to help the recovery of liver deposits, and balance deficiency states will be prescribed.
If any symptomatology related to Wernicke’s encephalopaty, Korsakoff syndrome is found, intramuscularly or intravenous thiamine administration will be considered.
Diazepam or Chlordiazepoxide are the preferred drug for withdrawal. The starting dose for diazepam usually is between 20 mg to 50 mg per day, and during the third and forth week it is reduced 5 to 10mg per week before it is suspended.
The starting dose for chlordiazepoxide range between 30 to 45 mg BD (depending on the severity of symptoms) during the first week, 15 to 30 mg BD the second week, and 10 to 30 mg OD during the third week. During the forth week the medication can be stopped, according to clinical judgement.
Chlormethiazole should not be prescribed because induces dependence, and in overdose or in combination with alcohol may cause respiratory failure and coma.
Therapeutic programmes for alcohol detoxification will last no les than 10 days. (Drug Misuse and Dependence – Guidelines on Clinical Management, 2007).
vitamin deficits
tremor
impaired memory
altered sensory or perception
chronic delusions
neuralgia
GI symptomatology (gastritis, ulcer, orthers)
or acute alcohol withdrawal, including Delirium Tremens.
Assessment of liver function is essential. LFT, proteins, hepatic enzymes, cholesterol, LDL, HDL, vitamin K, tests will be performed.
Appropriate hydration, vitamin and mineral therapy will be first considered.
Appropriate hydration consists of the necessary fluids and electrolytes to balance dehydration.
Vitamin B complex, or Vitamin B1 (thiamine) 50mg twice daily, for three weeks, to help the recovery of liver deposits, and balance deficiency states will be prescribed.
If any symptomatology related to Wernicke’s encephalopaty, Korsakoff syndrome is found, intramuscularly or intravenous thiamine administration will be considered.
Diazepam or Chlordiazepoxide are the preferred drug for withdrawal. The starting dose for diazepam usually is between 20 mg to 50 mg per day, and during the third and forth week it is reduced 5 to 10mg per week before it is suspended.
The starting dose for chlordiazepoxide range between 30 to 45 mg BD (depending on the severity of symptoms) during the first week, 15 to 30 mg BD the second week, and 10 to 30 mg OD during the third week. During the forth week the medication can be stopped, according to clinical judgement.
Chlormethiazole should not be prescribed because induces dependence, and in overdose or in combination with alcohol may cause respiratory failure and coma.
Therapeutic programmes for alcohol detoxification will last no les than 10 days. (Drug Misuse and Dependence – Guidelines on Clinical Management, 2007).