Newsgroups: sci.med,sci.med.nursing,sci.med.pharmacy
From: [jwat c h] at [world.std.com] (Journal Watch)
Subject: Journal Watch Summaries for August 30, 1994
Date: Tue, 30 Aug 1994 15:32:00 GMT


  This is Journal Watch, a medical-literature
survey produced by the Massachusetts Medical
Society.
  Twice a week, our physician-editors summarize
important new clinical research from a group
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  Contents copyright 1994, Mass. Medical Society.



Journal Watch Summaries for August 30, 1994

SYMPTOM-TRIGGERED TREATMENT FOR ALCOHOL WITHDRAWAL.
  JAMA 1994 Aug 17; 272:519-23.



SYMPTOM-TRIGGERED TREATMENT FOR ALCOHOL WITHDRAWAL.
   Benzodiazepines are effective for treating alcohol
withdrawal, but the usual fixed, "round the clock" dosing
schedule may expose patients to excess medication. This
double-blind, controlled trial evaluated a symptom-triggered
regimen in 101 patients admitted to an inpatient
detoxification unit at a Veterans Affairs medical center.
   Patients randomized to the fixed regimen received
chlordiazepoxide four times daily with additional medication
as needed. The symptom-triggered regimen provided
chlordiazepoxide only when signs and symptoms of alcohol
withdrawal developed. The severity of alcohol withdrawal was
measured by a validated scale based on physiologic signs and
symptoms.
   Compared with patients on the fixed schedule, those on
the symptom-triggered regimen had shorter treatment
durations (median, 9 vs. 68 hours) and received lower doses
of chlordiazepoxide (median, 100 vs. 425 mg). There were no
significant differences between the groups in the severity
of withdrawal symptoms.
   Comment: This study indicates that the round-the-clock
sedation regimens that are often used to treat alcohol
withdrawal represent more therapy than needed for many
patients. Symptom-triggered therapy tailored to each
patient's needs can be equally effective with less
medication. --TH Lee.
   Citation: Saitz R; et al. Individualized treatment for alcohol withdrawal:
a randomized double-blind controlled trial. JAMA 1994 Aug 17; 272:519-23.