Individualized Treatment for Alcohol Withdrawal. A Randomized Double-blind Controlled Trial

Symptom‐Driven Lorazepam Protocol for Treatment of Severe Alcohol Withdrawal Delirium in the Intensive Care Unit

“…[10][11][12] More recent studies focus on patients with alcohol withdrawal syndrome who do not have the severe manifestations of AWD and do not usually require admission to an ICU. [13][14][15][16][17][18][19] These studies report treatment success with relatively low doses of sedative agents. Symptom-driven protocols for alcohol withdrawal syndrome have been shown as effective as fixed-dose regimens with reduced amounts of benzodiazepine, [13][14][15] but there is no evidence for their use in patients with AWD.…”

“…[13][14][15][16][17][18][19] These studies report treatment success with relatively low doses of sedative agents. Symptom-driven protocols for alcohol withdrawal syndrome have been shown as effective as fixed-dose regimens with reduced amounts of benzodiazepine, [13][14][15] but there is no evidence for their use in patients with AWD. Benzodiazepine agents are the drugs of choice for alcohol withdrawal disorders, having been shown to reduce mortality, duration of symptoms, and complications, [20][21][22][23] but uncertainty remains regarding the optimum doses required for successful treatment of AWD.…”

Evaluation of a Symptom‐Triggered Protocol Approach to the Management of Alcohol Withdrawal Syndrome in Older Adults

“…6 In prospective and retrospective trials, symptom-triggered dosing regimens have allowed a lower total required benzodiazepine treatment dose than fixed-schedule dosing regimens. 2,10,11 In a symptom-triggered regimen, benzodiazepine dose administration is based on the individual's withdrawal progress as commonly assessed using the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scoring system. 2 The CIWA-Ar is a widely used and validated 10-item objective scale that aids in measuring withdrawal severity and guides symptom-triggered pharmacological management to avoid under-and overmedicating.…”

Compliance of an Institution‐Specific Alcohol Withdrawal Protocol with Evidence‐Based Practice Guidelines

“…Current evidencebased practice guidelines suggest that symptomtriggered regimens lead to decreased drug administration and more rapid detoxification. [2][3][4] However, these guidelines recommend against regimens that do not include benzodiazepines and that rely exclusively on drugs for treating adrenergic hyperactivity (e.g., clonidine) and/or delirium (e.g., haloperidol). According to these guidelines, benzodiazepines are considered firstline therapy when a patient's revised Clinical Institute Withdrawal Assessment for Alcohol scale 5 score exceeds 8 points.…”