2,493 results match your criteria Delirium Tremens


Benzodiazepines and/or neuroleptics for the treatment of delirium in palliative care?-a critical appraisal of recent randomized controlled trials.

Ann Palliat Med 2019 Mar 26. Epub 2019 Mar 26.

Department of Geriatric Psychiatry, University Hospital of Psychiatry, Zurich, Switzerland; Department of Geriatrics and Aging Research, Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland.

Delirium is a frequent condition in patients in a palliative care situation and most often associated with substantial burden or even danger for the persons concerned as well as caregivers and health-care-professionals. Despite the lack of randomized-controlled-trials (RCTs) benzodiazepines and neuroleptic agents are used extensively in palliative care for the pharmacological management of delirium. A focused review for RCTs assessing pharmacotherapy with benzodiazepines and neuroleptics for the treatment of delirium in patients treated in a palliative care or hospice setting published in 2017 was performed in PubMed. Read More

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http://dx.doi.org/10.21037/apm.2019.03.06DOI Listing
March 2019
1 Read

Symptom-Triggered Therapy for Alcohol Withdrawal Syndrome: a Systematic Review and Meta-analysis of Randomized Controlled Trials.

J Gen Intern Med 2019 Apr 1. Epub 2019 Apr 1.

Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.

Background: Benzodiazepines are the standard medication class for treating alcohol withdrawal. Guidelines recommend dosing based on objectively measured symptoms (symptom-triggered therapy) rather than fixed dose regimens. However, the superiority of symptom-triggered therapy has been questioned, and concerns have been raised about its inappropriate use and safety. Read More

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http://dx.doi.org/10.1007/s11606-019-04899-7DOI Listing
April 2019
3 Reads

Meningoencephalitis Caused by a Campylobacter fetus in a Patient with Chronic Alcoholism.

Intern Med 2019 Mar 28. Epub 2019 Mar 28.

Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan.

We herein report a case of Campylobacter fetus meningoencephalitis in a patient with chronic alcoholism. C. fetus is a rare cause of meningitis. Read More

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http://dx.doi.org/10.2169/internalmedicine.1486-18DOI Listing
March 2019
1 Read

Fatal familial insomnia and Agrypnia Excitata: Autonomic dysfunctions and pathophysiological implications.

Auton Neurosci 2019 May 26;218:68-86. Epub 2019 Feb 26.

Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy. Electronic address:

Fatal Familial Insomnia (FFI) is a hereditary prion disease caused by a mutation at codon 178 of the prion-protein gene leading to a D178N substitution in the protein determining severe and selective atrophy of mediodorsal and anteroventral thalamic nuclei. FFI is characterized by physiological sleep loss, which polygraphically appears to be a slow wave sleep loss, autonomic and motor hyperactivation with peculiar episodes of oneiric stupor. Alteration of autonomic functions is a great burden for FFI patients consisting in sympathetic overactivation, dysregulation of its physiological responses and disruption of circadian rhythms. Read More

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http://dx.doi.org/10.1016/j.autneu.2019.02.007DOI Listing
May 2019
5 Reads

Use of Phenobarbital in Alcohol Withdrawal Management - A Retrospective Comparison Study of Phenobarbital and Benzodiazepines for Acute Alcohol Withdrawal Management in General Medical Patients.

Psychosomatics 2019 Feb 14. Epub 2019 Feb 14.

Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA.

Background: Benzodiazepine-based protocols offer a standard of care for management of alcohol withdrawal, though they may not be safe or appropriate for all patients. Phenobarbital, a long-acting barbiturate, presents an alternative to conventional benzodiazepine treatment, though existing research offers only modest guidance to the safety and effectiveness of phenobarbital in managing alcohol withdrawal syndrome (AWS) in general hospital settings.

Methods: To compare clinical effectiveness of phenobarbital versus benzodiazepines in managing symptoms of alcohol withdrawal, we conducted a retrospective chart review of 562 patients admitted over a 2-year period to a general hospital and treated for AWS. Read More

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http://dx.doi.org/10.1016/j.psym.2019.02.002DOI Listing
February 2019
3 Reads

Alcohol withdrawal syndrome management: Is there anything new?

Rev Med Interne 2019 Mar 7. Epub 2019 Mar 7.

Hôpitaux universitaires Paris Ouest, Department of Psychiatry and Addictology, AP-HP, 75015 Paris, France; Faculté de médecine, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; U 894, Centre Psychiatrie et Neurosciences, Inserm, 75014 Paris, France.

Patients with alcohol use disorder experience frequently alcohol withdrawal syndrome (AWS), which is a potentially life-threatening condition mainly caused by glutamate overactivity. The aim of therapeutic alcohol withdrawal is the entry into a process of complete and lasting abstinence. Therefore preparing withdrawal is crucial to optimize compliance and efficacy of aftercare. Read More

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http://dx.doi.org/10.1016/j.revmed.2019.02.001DOI Listing
March 2019
1 Read

Single dose phenobarbital in addition to symptom-triggered lorazepam in alcohol withdrawal.

Authors:
Francisco Ibarra

Am J Emerg Med 2019 Jan 30. Epub 2019 Jan 30.

Community Regional Medical Center, P.O. Box 1232, Fresno, CA 93715, United States of America. Electronic address:

Objective: The purpose of this study was to evaluate the safety and efficacy of a single parenteral dose of phenobarbital in addition to symptom-triggered lorazepam for the acute management of alcohol withdrawal syndrome (AWS).

Methods: This was a retrospective chart review of adult patients who presented to the Emergency Department with moderate or severe symptoms of alcohol withdrawal. Patients were included if they received at least 4 mg of lorazepam through the hospital's Alcohol Withdrawal Order Set on hospital day one. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.053DOI Listing
January 2019
7 Reads

Evaluation of the Brief Alcohol Withdrawal Scale Protocol at an Academic Medical Center.

J Addict Med 2019 Feb 6. Epub 2019 Feb 6.

Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD (BKL, VTG, RMK, ASJ); Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (AAHA, TN); Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (ESC); Department of Medicine, The Johns Hopkins Hospital, Baltimore, MD (PM, KP); Center for Chemical Dependence, Johns Hopkins Bayview Medical Center, Baltimore, MD (DAR); Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD (SY).

Objectives: The standard of care for treatment of alcohol withdrawal is symptom-triggered dosing of benzodiazepines using a withdrawal scale. Abbreviated scales are desired for clinician efficiency. The objective of this study was to evaluate the use of the 5-item Brief Alcohol Withdrawal Scale (BAWS) protocol. Read More

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http://dx.doi.org/10.1097/ADM.0000000000000510DOI Listing
February 2019
14 Reads

Effect of early and focused benzodiazepine therapy on length of stay in severe alcohol withdrawal syndrome.

Clin Toxicol (Phila) 2019 Feb 7:1-4. Epub 2019 Feb 7.

b Department of Surgery , University of California, Davis Medical Center , Sacramento , CA, USA.

Objective: Current evidence supports symptom-triggered therapy for alcohol withdrawal syndrome (AWS). Early, escalating therapy with benzodiazepines (BZD) appears to decrease ICU length of stay (LOS); however, the effect on hospital LOS remains unknown. The hypothesis of this study is that focused BZD treatment in the first 24 h will decrease hospital LOS. Read More

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http://dx.doi.org/10.1080/15563650.2018.1542701DOI Listing
February 2019
5 Reads

Baclofen and the Alcohol Withdrawal Syndrome-A Short Review.

Front Psychiatry 2018 22;9:773. Epub 2019 Jan 22.

Kershaw Unit, Gartnavel Royal Hospital, Glasgow, United Kingdom.

The Alcohol Withdrawal Syndrome (AWS), which may occur with or without delirium, is a frequent consequence of sudden alcohol cessation in patients with moderate to severe Alcohol Dependence Syndrome (ADS). Withdrawal as a result of habituation to alcohol is part of the definition of the Alcohol Dependence Syndrome (ICD10). Since the recognition of Delirium Tremens, in the early nineteenth century, the management of the syndrome, an acute medical emergency, has proven controversial. Read More

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http://dx.doi.org/10.3389/fpsyt.2018.00773DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349735PMC
January 2019
10 Reads

Pellagra and Alcohol Dependence Syndrome: Findings From a Tertiary Care Addiction Treatment Centre in India.

Alcohol Alcohol 2019 Feb 5. Epub 2019 Feb 5.

Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, India.

Aim: To define the prevalence and clinical presentation of pellagra, a multi-systemic disease caused by the deficiency of niacin, in patients admitted to a tertiary addiction treatment centre in southern India, with alcohol dependence syndrome (ADS)-(ICD10).

Methods: Review of the health records of 2947 patients who received inpatient care for ADS between 2015 and 2017.

Results: Out of 2947, 31 (1%) were diagnosed with pellagra. Read More

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http://dx.doi.org/10.1093/alcalc/agz004DOI Listing
February 2019
10 Reads

Alcohol and delirium tremens: effects of average number of drinks per day and beverage type.

Acta Psychiatr Scand 2019 Jan 29. Epub 2019 Jan 29.

National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.

Objective: Associations of amount of alcohol intake and beverage type with the risk of delirium tremens (DT) have not been studied. This longitudinal study investigated if the average number of drinks per day and beverage type predict DT.

Methods: A cohort of 3 582 alcohol-dependent men and women aged 19-82 without previous DT were interviewed about alcohol intake and beverage type at baseline in 1994-2005 and followed through record linkage in Danish nationwide registers to identify incident DT. Read More

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http://dx.doi.org/10.1111/acps.13006DOI Listing
January 2019
3 Reads

Deprescribing in the Pharmacologic Management of Delirium: A Randomized Trial in the Intensive Care Unit.

J Am Geriatr Soc 2019 Apr 21;67(4):695-702. Epub 2019 Jan 21.

Indiana University Center for Aging Research, Indianapolis, Indiana.

Objective: Benzodiazepines and anticholinergics are risk factors for delirium in the intensive care unit (ICU). We tested the impact of a deprescribing intervention on short-term delirium outcomes.

Design: Multisite randomized clinical trial. Read More

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http://dx.doi.org/10.1111/jgs.15751DOI Listing
April 2019
5 Reads

Remission from Alcohol Use Disorder among Males in the Lundby Cohort during 1947-1997.

Psychiatry J 2018 16;2018:4829389. Epub 2018 Dec 16.

Institute of Clinical Sciences Lund, Department of Psychiatry, Lund University, Baravägen 1, 221 85 Lund, Sweden.

Background: Alcohol use disorders are a major health problem, often with a chronic course. Studies on remission from alcohol use disorders are sparse.

Objective: The aim of this study was to analyse the rate of remission from AUD and the possible influence of other mental disorders and sociodemographic factors on the remission in the Lundby Cohort. Read More

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https://www.hindawi.com/journals/psychiatry/2018/4829389/
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http://dx.doi.org/10.1155/2018/4829389DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311273PMC
December 2018
9 Reads

Delirium Tremens: Assessment and Management.

J Clin Exp Hepatol 2018 Dec 5;8(4):460-470. Epub 2018 May 5.

Assistant Professor, Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Delirium Tremens (DT) falls in the most severe spectrum of alcohol withdrawal, which could potentially result in death, unless managed promptly and adequately. The prevalence of DT in general population is <1% and nearly 2% in patients with alcohol dependence. DT presents with a combination of severe alcohol withdrawal symptoms and symptoms of delirium with agitation and sometimes hallucination. Read More

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http://dx.doi.org/10.1016/j.jceh.2018.04.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286444PMC
December 2018
3 Reads

Recognition, Assessment, and Pharmacotherapeutic Treatment of Alcohol Withdrawal Syndrome in the Intensive Care Unit.

Crit Care Nurs Q 2019 Jan/Mar;42(1):12-29

Department of Pharmacy Services, UC Health-University of Cincinnati Medical Center, Ohio (Drs Foertsch, Winter, Droege, and Ernst); University of Cincinnati James L. Winkle College of Pharmacy, Ohio (Drs Foertsch, Winter, Rhoades, Martin, Droege, and Ernst); Department of Pharmacy Services, The Christ Hospital Health Network, Cincinnati, Ohio (Dr Rhoades); and Department of Pharmacy Services, St Elizabeth Healthcare, Edgewood, Kentucky (Dr Martin).

Alcohol withdrawal syndrome (AWS) is a complex neurologic disorder that develops after an acute reduction in or cessation of chronic alcohol consumption that alters neurotransmitter conduction. The incidence of AWS in the intensive care unit varies, but has been associated with poor outcomes. This is primarily driven by downregulation of gamma-aminobutyric acid (GABA) leading to autonomic excitability and psychomotor agitation. Read More

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http://dx.doi.org/10.1097/CNQ.0000000000000233DOI Listing
March 2019
5 Reads

Comparison of phenobarbital-adjunct versus benzodiazepine-only approach for alcohol withdrawal syndrome in the emergency department.

Am J Emerg Med 2018 Oct 11. Epub 2018 Oct 11.

School of Pharmacy, University of Sydney, Royal Prince Alfred Hospital, Pharmacy and Bank Building (A15), Camperdown Campus, Sydney, New South Wales 2006, Australia. Electronic address:

Objectives: To compare a phenobarbital-adjunct versus benzodiazepine-only approach for the management of alcohol withdrawal syndrome in the emergency department (ED) with regard to the need for intensive care unit (ICU) admission, severity of symptoms on ED discharge, and complications.

Methods: This was a retrospective cohort study conducted in two academic EDs in the United States. Adult patients seen in the ED with a diagnosis of alcohol withdrawal syndrome were included. Read More

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http://dx.doi.org/10.1016/j.ajem.2018.10.007DOI Listing
October 2018
40 Reads

Protracted delirium tremens and the forgotten cation: A case report.

Asian J Psychiatr 2018 Dec 24;38:29-30. Epub 2018 Oct 24.

Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India. Electronic address:

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http://dx.doi.org/10.1016/j.ajp.2018.10.020DOI Listing
December 2018
3 Reads

Election bans and alcohol banes: The impact of elections on treatment referrals at a tertiary addiction treatment facility in India.

Asian J Psychiatr 2018 Dec 23;38:27-28. Epub 2018 Oct 23.

Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur road, Bengaluru 560029, India. Electronic address:

Pattern of alcohol use and its related complications is determined by multiple factors. We studied the effects of sudden ban of alcohol during elections in a state of India. We found that unexpected election bans could lead to severe complications in alcohol dependent individuals. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762018183097
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http://dx.doi.org/10.1016/j.ajp.2018.10.019DOI Listing
December 2018
9 Reads

[Management of alcohol withdrawal].

Authors:
C Hanak

Rev Med Brux 2018;39(4):241-245

Service de Psychiatrie-Addictologie, CHU Brugmann, ULB.

This article proposes an update and summary of current knowledge in the management of alcohol withdrawal, based on a review of recent literature. The issues open to debate and the areas whith new developments will be addressed, such as: the entry into treatment, the withdrawal setting, the withdrawal medications, the various possible protocols and the introduction of relapse prevention treatments. Read More

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December 2018
8 Reads

Alcohol Withdrawal Assessment Tool: Validity and Reliability Testing in Acute Care.

Clin Nurse Spec 2018 Nov/Dec;32(6):307-312

Author Affiliations: Clinical Nurse Specialists (Mss Davis and Keen), Indiana University Health, University Hospital, Indianapolis; Clinical Nurse Specialist (Mr Holly), Indiana University Health, Bloomington Hospital; Clinical Nurse Specialist (Ms Balaguras), Indiana University Health, Bloomington Hospital; and Assistant Professor (Dr Miller), Indiana University School of Nursing, Indianapolis.

Purpose/aims: The purpose of this study was to validate a tool to assess alcohol withdrawal in acute care patients. Study aims included (1) establish content validity, (2) examine criterion-related validity, (3) test interrater reliability, and (4) assess nurse usability.

Design: A psychometric research study was designed to evaluate the Alcohol Withdrawal Assessment Tool. Read More

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http://Insights.ovid.com/crossref?an=00002800-201811000-0000
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http://dx.doi.org/10.1097/NUR.0000000000000408DOI Listing
October 2018
10 Reads

Benzodiazepines for agitation in patients with delirium: selecting the right patient, right time, and right indication.

Authors:
David Hui

Curr Opin Support Palliat Care 2018 12;12(4):489-494

Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, USA.

Purpose Of Review: To provide an evidence-based synopsis on the role of benzodiazepines in patients with agitated delirium.

Recent Findings: Existing evidence supports the use of benzodiazepines in two specific delirium settings: persistent agitation in patients with terminal delirium and delirium tremens. In the setting of terminal delirium, the goal of care is to maximize comfort, recognizing that patients are unlikely to recover from their delirium. Read More

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http://dx.doi.org/10.1097/SPC.0000000000000395DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261485PMC
December 2018
5 Reads

Early recovery following traumatic brain injury and alcohol withdrawal management.

Rehabil Psychol 2018 Nov 13;63(4):588-594. Epub 2018 Sep 13.

Department of Physical Medicine and Rehabilitation.

Purpose: To compare recovery experienced during inpatient rehabilitation among individuals with traumatic brain injury (TBI) based on whether their acute care included the Clinical Institute Withdrawal Assessment for Alcohol (CIWA) protocol.

Design: Participants included 234 individuals with TBI who completed inpatient rehabilitation at a TBI Model Systems site. Of these, 67 patients were treated using the CIWA protocol (TBI + CIWA); 167 patients were treated for TBI alone (TBI only). Read More

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http://dx.doi.org/10.1037/rep0000240DOI Listing
November 2018
5 Reads

Diagnosis and treatment of acute alcohol intoxication and alcohol withdrawal syndrome: position paper of the Italian Society on Alcohol.

Intern Emerg Med 2019 Jan 5;14(1):143-160. Epub 2018 Sep 5.

Regional Centre on Alcohol, Genoa, Italy.

The chronic use of alcohol can lead to the onset of an alcohol use disorder (AUD). About 50% of subjects with an AUD may develop alcohol withdrawal syndrome (AWS) when they reduce or discontinue their alcohol consumption and, in 3-5% of them, convulsions and delirium tremens (DTs), representing life-threatening complications, may occur. Unfortunately, few physicians are adequately trained in identifying and treating AWS. Read More

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http://dx.doi.org/10.1007/s11739-018-1933-8DOI Listing
January 2019
6 Reads
2.624 Impact Factor

Delirium tremens in an AUD patient after an intrathecal baclofen pump induced total alcohol abstinence.

Eur Rev Med Pharmacol Sci 2018 Aug;22(16):5371-5376

Department of Anesthesia, Anesthesia and Chronic Pain, McMaster University, Hamilton, Ontario, Canada

Objective: Delirium Tremens (DT) is the most severe complication of alcohol withdrawal syndrome (AWS), and has a mortality rate of 1-5%. Baclofen is recommended for spasticity treatment, but it has recently been used for alcohol withdrawal symptoms reduction and alcohol abstinence.

Case Report: A cervical spinal cord injury patient was treated for two years with oral baclofen 80 mg/day for spasticity. Read More

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http://dx.doi.org/10.26355/eurrev_201808_15738DOI Listing
August 2018
20 Reads

Will This Hospitalized Patient Develop Severe Alcohol Withdrawal Syndrome?: The Rational Clinical Examination Systematic Review.

JAMA 2018 08;320(8):825-833

British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.

Importance: Although severe alcohol withdrawal syndrome (SAWS) is associated with substantial morbidity and mortality, most at-risk patients will not develop this syndrome. Predicting its occurrence is important because the mortality rate is high when untreated.

Objective: To assess the accuracy and predictive value of symptoms and signs for identifying hospitalized patients at risk of SAWS, defined as delirium tremens, withdrawal seizure, or clinically diagnosed severe withdrawal. Read More

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http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.20
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http://dx.doi.org/10.1001/jama.2018.10574DOI Listing
August 2018
7 Reads
35.290 Impact Factor

Medications for Alcohol Use Disorder and Predicting Severe Withdrawal.

Authors:
Richard Saitz

JAMA 2018 08;320(8):766-768

Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.

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http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.20
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http://dx.doi.org/10.1001/jama.2018.10061DOI Listing
August 2018
15 Reads

The role of OPRM1 polymorphism in the etiology of alcoholism.

Adv Clin Exp Med 2019 02;28(2):199-202

Department of Psychiatry, Faculty of Medicine, Pomeranian Medical University in Szczecin, Poland.

Background: Numerous studies have investigated the association between the OPRM1 A118G polymorphism (rs1799971) and alcohol dependence, but the results have been inconsistent. The endogenous opioid system has been implicated in the development of alcohol dependence for its prominent role in the central rewarding mechanism.

Objectives: The aim of this study was to evaluate the role of the A118G polymorphism of the OPRM1 gene in the pathogenesis of alcohol dependence syndrome (ADS). Read More

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http://dx.doi.org/10.17219/acem/78592DOI Listing
February 2019
10 Reads

Clinical management of gamma-hydroxybutyrate (GHB) withdrawal delirium with CIWA-Ar protocol.

J Formos Med Assoc 2018 Dec 19;117(12):1124-1127. Epub 2018 Jun 19.

Taipei City Psychiatric Center, Taipei City Hospital, Addiction Psychiatry Department, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan. Electronic address:

Gamma-hydroxybutyrate (GHB) is a synthetic drug used mainly for recreational purpose. Although the prevalence of GHB abuse is low in Taiwan, GHB has become increasingly popular in certain subpopulations such as clubbers and men who have sex with men (MSM). GHB dependence could be associated with severe withdrawal syndrome including hallucinations and delirium. Read More

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http://dx.doi.org/10.1016/j.jfma.2018.06.005DOI Listing
December 2018
3 Reads

Alcohol withdrawal syndrome: diagnostic and therapeutic methods.

Riv Psichiatr 2018 May-Jun;53(3):118-122

Centro Riferimento Alcologico Regione Lazio (CRARL), Sapienza University of Rome, Italy.

Alcohol withdrawal syndrome (AWS) is a medical emergency, rare in the general population, but very common among alcoholic individuals, which can lead to severe complications when unrecognized or late treated. It represents a clinical condition which can evolve in few hours or days following an abrupt cessation or reduction of alcohol intake and is characterized by hyperactivity of the autonomic nervous system resulting in the development of typical symptoms. According to DSM-5 criteria, the alcohol withdrawal syndrome is defined as such: if patients present at least two of typical signs and symptoms. Read More

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http://dx.doi.org/10.1708/2925.29413DOI Listing
January 2019
8 Reads

Implementation of an ICU-Specific Alcohol Withdrawal Syndrome Management Protocol Reduces the Need for Mechanical Ventilation.

Pharmacotherapy 2018 May 25. Epub 2018 May 25.

Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut.

Study Objective: Alcohol use disorders are prevalent and put patients at risk for developing alcohol withdrawal syndrome (AWS). Treatment of AWS with a symptom-triggered protocol standardizes management and may avoid AWS-related complications. The objective of this study was to evaluate whether implementation of a specific intensive care unit (ICU) symptom-triggered protocol for the management of AWS was associated with improved clinical outcomes and, in particular, would reduce the risk of patients with AWS requiring mechanical ventilation. Read More

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http://doi.wiley.com/10.1002/phar.2127
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http://dx.doi.org/10.1002/phar.2127DOI Listing
May 2018
12 Reads

Adjunctive Use of Ketamine for Benzodiazepine-Resistant Severe Alcohol Withdrawal: a Retrospective Evaluation.

J Med Toxicol 2018 Sep 10;14(3):229-236. Epub 2018 May 10.

Department of Emergency Medicine, Advocate Christ Medical Center, 4440 95th St., Oak Lawn, IL, 60453, USA.

Introduction: Benzodiazepine (BZD)-resistant alcohol withdrawal remains a challenge for most institutions due to limited evidence with available agents. One published study currently exists utilizing the N-methyl-D-aspartate antagonist, ketamine, for alcohol withdrawal.

Objective: The purpose of our study was to evaluate the effect of adjunctive ketamine continuous infusion on symptom control and lorazepam infusion requirements for BZD-resistant alcohol withdrawal patients in the intensive care unit. Read More

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http://dx.doi.org/10.1007/s13181-018-0662-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097970PMC
September 2018
3 Reads

Adjunct Ketamine Use in the Management of Severe Ethanol Withdrawal.

Crit Care Med 2018 Aug;46(8):e768-e771

Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA.

Objectives: Ketamine offers a plausible mechanism with favorable kinetics in treatment of severe ethanol withdrawal. The purpose of this study is to determine if a treatment guideline using an adjunctive ketamine infusion improves outcomes in patients suffering from severe ethanol withdrawal.

Design: Retrospective observational cohort study. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003204DOI Listing
August 2018
9 Reads

Systematic review of prediction models for delirium in the older adult inpatient.

BMJ Open 2018 04 28;8(4):e019223. Epub 2018 Apr 28.

Department of Anesthesiology, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA.

Objective: To identify existing prognostic delirium prediction models and evaluate their validity and statistical methodology in the older adult (≥60 years) acute hospital population.

Design: Systematic review.

Data Sources And Methods: PubMed, CINAHL, PsychINFO, SocINFO, Cochrane, Web of Science and Embase were searched from 1 January 1990 to 31 December 2016. Read More

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http://dx.doi.org/10.1136/bmjopen-2017-019223DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5931306PMC
April 2018
8 Reads

An open prospective pilot study of a herbal combination "Relief" as a supportive dietetic measure during alcohol withdrawal.

Neuro Endocrinol Lett 2018 Mar;39(1):1-8

OncoTherapeutica, Inc., MA, USA.

Objective: A herbal combination (saffron extract, passion flower herb extract, cocoa seed extract, radish extract and black cumin extract) called "Relief" was designed as a supportive therapy of alcohol withdrawal syndrome (AWS). This combination was based on the scientific evidence of each constituent effect on AWS-like symptoms. In addition, our preclinical studies have shown the effectiveness of Relief on AWS detoxification. Read More

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March 2018
7 Reads

Delirium Tremens and Takotsubo Syndrome: A Role of Monitoring the Autonomic Sympathetic Nervous System?

Authors:
John E Madias

Psychosomatics 2018 11 12;59(6):622. Epub 2018 Mar 12.

Icahn School of Medicine at Mount Sinai, New York, NY; Division of Cardiology, Elmhurst Hospital Center, Elmhurst, NY. Electronic address:

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http://dx.doi.org/10.1016/j.psym.2018.01.009DOI Listing
November 2018
10 Reads

An exploratory study of candidate gene(s) for Delirium Tremens: Adding the new cholinergic dimension to the conundrum.

Asian J Psychiatr 2018 Jan 12;31:137-141. Epub 2018 Feb 12.

Postgraduate Institute of Medical Education & Research, Chandigarh, India.

Background And Aims: Delirium Tremens (DT) is the most severe form of alcohol withdrawal syndrome, with a potential risk of mortality. Search for the predictors of DT led to study of candidate genes, with inconsistent and inconclusive results. This study aimed to explore the association of various candidate gene polymorphisms and DT in a case-control design. Read More

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http://dx.doi.org/10.1016/j.ajp.2018.02.003DOI Listing
January 2018
14 Reads

Comparison of Lurasidone Versus Quetiapine for the Treatment of Delirium in Critically Ill Patients.

J Intensive Care Med 2018 Jan 1:885066617754187. Epub 2018 Jan 1.

1 Orlando Health, Orlando, FL, USA.

Objective: To evaluate the efficacy and safety of lurasidone compared with quetiapine for treatment of delirium in critically ill patients.

Design: Prospective, observational cohort study.

Setting: Single-center community teaching hospital. Read More

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http://dx.doi.org/10.1177/0885066617754187DOI Listing
January 2018
7 Reads

A Possible Role of Takotsubo Cardiomyopathy in Ventricular Fibrillation During Delirium Tremens: A Case Report and Literature Review.

Psychosomatics 2018 May - Jun;59(3):293-297. Epub 2017 Nov 24.

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Department of Neuropsychiatry and Clinical Ethics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.

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https://linkinghub.elsevier.com/retrieve/pii/S00333182173022
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http://dx.doi.org/10.1016/j.psym.2017.11.008DOI Listing
April 2019
12 Reads

Symptom-Triggered Detoxification Using the Alcohol-Withdrawal-Scale Reduces Risks and Healthcare Costs.

Alcohol Alcohol 2018 Jan;53(1):71-77

University Hospital of Psychiatry, University of Bern, Switzerland.

Aims: As there are only a few existing experimental studies on symptom-triggered therapy for patients with alcohol withdrawal, we investigated the effectiveness of symptom-triggered detoxification regarding the use and dosage of benzodiazepine and withdrawal complications in a naturalistic clinical setting of a specialized treatment center for alcohol use disorder.

Methods: In total, 301 charts of patients who entered residential treatment for alcohol withdrawal were included in the retrospective analysis. Charts of 176 patients treated with the Alcohol Withdrawal-Scale (AWS) were compared to the charts of 125 patients treated with treatment as usual (TAU) before the implementation of AWS. Read More

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http://dx.doi.org/10.1093/alcalc/agx080DOI Listing
January 2018
10 Reads

Patient Outcomes Associated With Phenobarbital Use With or Without Benzodiazepines for Alcohol Withdrawal Syndrome: A Systematic Review.

Hosp Pharm 2017 Oct 17;52(9):607-616. Epub 2017 Jul 17.

University of Pittsburgh School of Pharmacy, PA, USA.

Benzodiazepines are the drug of choice for alcohol withdrawal syndrome (AWS); however, phenobarbital is an alternative agent used with or without concomitant benzodiazepine therapy. In this systematic review, we evaluate patient outcomes with phenobarbital for AWS. Medline, Cochrane Library, and Scopus were searched from 1950 through February 2017 for controlled trials and observational studies using ["phenobarbital" or "barbiturate"] and ["alcohol withdrawal" or "delirium tremens. Read More

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http://journals.sagepub.com/doi/full/10.1177/001857871772031
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http://dx.doi.org/10.1177/0018578717720310DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735736PMC
October 2017
20 Reads

Incidence rates of admissions associated with alcohol withdrawal syndrome in Spain: Analysis of minimum basic data set 1999-2010.

Med Clin (Barc) 2018 Aug 21;151(3):103-108. Epub 2017 Dec 21.

Servicio de Epidemiología y Estadística, Complejo Universitario Hospitalario de A Coruña, A Coruña, España.

Background: There are no data on the incidence of admissions associated with alcohol withdrawal syndrome (AWS) or about its trend over time in Spain.

Objective: To analyze the characteristics, incidence rates and trends over time of hospital admissions associated with AWS in Spanish public hospitals.

Material And Method: Analysis from the Spanish public hospitals minimum basic data set of hospital admissions with AWS (CIE9-MC 291. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00257753173090
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http://dx.doi.org/10.1016/j.medcli.2017.11.021DOI Listing
August 2018
63 Reads

Opioid Withdrawal Presenting as Delirium and Role of Buprenorphine: A Case Series.

Indian J Psychol Med 2017 Sep-Oct;39(5):665-667

Antara Psychiatric Centre, Sri Aurobindo Seva Kendra, Kolkata, West Bengal, India.

Opioid withdrawal is very rarely characterized by delirium unlike alcohol or benzodiazepine withdrawal. PubMed search through October 2016 reveals only two case series on delirium as feature of withdrawal in opioid dependence syndrome. We report two cases of opioid withdrawal (heroin) presenting with delirium when low-dose buprenorphine (2 mg/day) was added. Read More

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http://dx.doi.org/10.4103/0253-7176.217027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688897PMC
December 2017
8 Reads

The Addition of Dexmedetomidine as an Adjunctive Therapy to Benzodiazepine Use in Alcohol Withdrawal Syndrome: A Literature Review.

J Addict Nurs 2017 Oct/Dec;28(4):E1-E2

Alcohol withdrawal syndrome (AWS) is commonly encountered in the intensive care unit population. Currently, the mainstay treatment for AWS is the use of benzodiazepines. However, some patients are refractory to benzodiazepine treatment due to heavy alcohol abuse. Read More

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http://dx.doi.org/10.1097/JAN.0000000000000205DOI Listing
May 2018
22 Reads

The Addition of Dexmedetomidine as an Adjunctive Therapy to Benzodiazepine Use in Alcohol Withdrawal Syndrome: A Literature Review.

J Addict Nurs 2017 Oct/Dec;28(4):188-195

Tarenne A. Ferenchak, BA, BSN, MSN, RN, College of Nursing, Thomas Jefferson University, Philadelphia, Pennsylvania.

Alcohol withdrawal syndrome (AWS) is commonly encountered in the intensive care unit population. Currently, the mainstay treatment for AWS is the use of benzodiazepines. However, some patients are refractory to benzodiazepine treatment due to heavy alcohol abuse. Read More

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http://dx.doi.org/10.1097/JAN.0000000000000191DOI Listing
May 2018
8 Reads