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Once a baseline dose is determined, the medication is tapered over the ensuing 3 to 10 days. Another option is to give a standard dose of benzodiazepine based on history and adjust based on withdrawal phenomenon. A third option is to defer treatment until symptoms occur. This method should not be used in patients with prior, alcohol-related ...
A randomized, double blind trial published in JAMA in 1994 [5] showed that management for alcohol withdrawal that was guided by the CIWA scale resulted in decreased treatment duration and total use of benzodiazepines. The goal of the CIWA scale is to provide an efficient and objective means of assessing alcohol withdrawal.
The protracted withdrawal syndrome from benzodiazepines, opioids, alcohol and other addictive substances can produce symptoms identical to generalized anxiety disorder as well as panic disorder. Due to the sometimes prolonged nature and severity of benzodiazepine, opioid and alcohol withdrawal, abrupt cessation is not advised. [13]
alcohol (alcoholic beverage) (cf. alcohol dependence, alcohol withdrawal, delirium tremens) [11] barbiturates such as phenobarbital, sodium thiopental and secobarbital; benzodiazepines such as diazepam (Valium), lorazepam (Ativan), and alprazolam (Xanax) (see benzodiazepine dependence and benzodiazepine withdrawal syndrome)
Benzodiazepine withdrawal syndrome (BZD withdrawal) is the cluster of signs and symptoms that may emerge when a person who has been taking benzodiazepines as prescribed develops a physical dependence on them and then reduces the dose or stops taking them without a safe taper schedule.
Ethanol (alcohol) has a very similar mechanism of tolerance and withdrawal to benzodiazepines, involving the GABA A receptors, NMDA receptors and AMPA receptors, but the majority of research into kindling has primarily focused on alcohol. [6] An intensification of anxiety and other psychological symptoms of alcohol withdrawal also occurs. [10]