Pharmacological treatment: Detoxification

Authors

  • P.A. Soler Servicio Psiquiatría. Hospital Mútua de Terrassa. (Barcelona).
  • M. Guasch Servicio Psiquiatría. Hospital Mútua de Terrassa. (Barcelona).

DOI:

https://doi.org/10.20882/adicciones.536

Keywords:

alcohol abstinence, evaluation, intensity, treatment pharmacotherapy

Abstract

Alcoholic abstinence syndrome is produced by the abrupt reduction of alcoholism in individuals with neuroadaptation to alcohol. Deprivation leads to alterations in diverse neurotransmitter systems, provoking a noradrenergic hyperactivity, an increase in NMDA receptor sensitivity and GABA inhibition. Alcohol abstinence syndrome may be objectified through several scales (Ciwa, Soler Insa) that enable the intensity of abstinence to be assessed. The more contrasted treatment guidelines are adapted in accordance with the severity of the case. In addition, the set guidelines are given which are also utilised and published, but by less reliable authors. Chlormethiazole, tetrabamate and the benzodiazepines are the most used drugs and the ones on which more data exists on efficacy and safety but details are given of certain studies with other drugs such as carbamazephine and other anticonvulsivants, the beta-blockers, the alpha2 antagonists, the calcium antagonists and others. Lastly, therapeutic recommendations are given for special cases such as delirium tremens, convulsions during abstinence, cases of pregnant women, the old or the post operational patient.

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Published

2002-12-15

Issue

Section

Originals