Benzodiazepines and Beyond: Updates on Management of Alcohol Withdrawal-View Presentation

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The conference on managing alcohol withdrawal, led by Dr. Michael Weaver and his colleagues from the University of Texas Health Science Center, Houston, provided insights into both traditional and newer approaches in treating alcohol withdrawal syndrome. Dr. Weaver introduced the team and highlighted upcoming programs at UT Houston Health for those interested in joining the field.<br /><br />The discussions detailed the neurobiology of alcohol withdrawal, focusing on neurotransmitter imbalances involving GABA, glutamate, and norepinephrine. Studies were cited to showcase the impact of alcohol exposure on these neurotransmitters, leading to withdrawal symptoms.<br /><br />Different scales for assessing alcohol withdrawal were compared, with the CIWA scale being the most common but criticized for its subjectivity. The PAWS scale was introduced as a newer tool that predicts the risk of severe withdrawal, emphasizing objective measures like blood alcohol levels and history of seizures.<br /><br />Dr. Manohar discussed the use of non-benzodiazepine alternatives, including anticonvulsants and alpha-2 agents, which can help in managing withdrawal symptoms while avoiding common benzodiazepine side effects such as sedation and respiratory depression. The meta-analysis presented showed gabapentin and carbamazepine as effective alternatives to traditional benzodiazepines like Ativan.<br /><br />The session emphasized customization in withdrawal management strategies, considering patient-specific factors like comorbidities. Highlighting the challenges in withdrawal prediction, attendees were encouraged to consider both pharmacological and non-pharmacological interventions, tailored to individual patient needs. The session concluded with questions from attendees, focusing on integrating these strategies effectively into clinical practice.

Keywords

alcohol withdrawal

Dr. Michael Weaver

University of Texas Health Science Center

neurobiology

GABA

glutamate

norepinephrine

CIWA scale

PAWS scale

non-benzodiazepine alternatives

gabapentin

carbamazepine

customized management strategies