Clinical utility of benzodiazepine in the management of alcohol withdrawal syndrome in a tertiary care teaching hospital

Abstract

Background: Alcohol dependence is one of the common psychiatric disorder which is characterized by a pathological pattern of alcohol use, effecting mental health. Patients show severe symptoms, requiring clinical intervention. Benzodiazepines treatment can decrease the severity of withdrawal symptoms, and incidence of seizures and delirium tremens after abrupt cessation of alcohol. Objectives: To check the severity of alcohol use and assess the alcohol withdrawal symptoms, and to monitor the efficacy of different Benzodiazepines in alcohol detoxification. Methodology: A prospective study of eight months’ duration, conducted in the de-addiction unit attached to Psychiatric department (in-patients). A suitable data collection form was designed. All patients were screened using AUDIT scale and CIWA-Ar scale was used to assess the duration and severity of AWS. Data were analysed using descriptive statistics. Results: 220 patients were included in the study. Mean AUDIT score was 25.74, all the patients scored 8 or more on AUDIT. Majority of the patients were observed to have an AUDIT score between 25-32. A gradual decrease of signs and symptoms in each patient were observed. All patients were prescribed with Benzodiazepine, among which 135 (61.36%) patients were prescribed with Lorazepam followed by 85 (38.63%) patients with Diazepam and Chlordiazepoxide. Conclusion: Even though both Lorazepam and Diazepam are equally effective Benzodiazepines, in the present study, we observed that Lorazepam is the most commonly prescribed. The choices of drugs differ for each patient, and is patient specific. The management works best when it is individualized with the help of rating scales.