Bayard Max, McIntyre Jonah, Hill Keith R, Woodside Jack
Department of Family Medicine, East Tennessee State University, James H. Quillen College of Medicine, Johnson City, Tennessee 37614, USA.
Am Fam Physician. 2004 Mar 15;69(6):1443-50.
The spectrum of alcohol withdrawal symptoms ranges from such minor symptoms as insomnia and tremulousness to severe complications such as withdrawal seizures and delirium tremens. Although the history and physical examination usually are sufficient to diagnose alcohol withdrawal syndrome, other conditions may present with similar symptoms. Most patients undergoing alcohol withdrawal can be treated safely and effectively as outpatients. Pharmacologic treatment involves the use of medications that are cross-tolerant with alcohol. Benzodiazepines, the agents of choice, may be administered on a fixed or symptom-triggered schedule. Carbamazepine is an appropriate alternative to a benzodiazepine in the outpatient treatment of patients with mild to moderate alcohol withdrawal symptoms. Medications such as haloperidol, beta blockers, clonidine, and phenytoin may be used as adjuncts to a benzodiazepine in the treatment of complications of withdrawal. Treatment of alcohol withdrawal should be followed by treatment for alcohol dependence.
酒精戒断症状的范围从失眠和震颤等轻微症状到戒断性癫痫发作和震颤谵妄等严重并发症。虽然病史和体格检查通常足以诊断酒精戒断综合征，但其他病症可能表现出类似症状。大多数正在经历酒精戒断的患者作为门诊病人可以得到安全有效的治疗。药物治疗涉及使用与酒精有交叉耐受性的药物。苯二氮䓬类药物是首选药物，可按固定或症状触发方案给药。在门诊治疗有轻至中度酒精戒断症状的患者时，卡马西平是苯二氮䓬类药物的合适替代药物。在治疗戒断并发症时，如氟哌啶醇、β受体阻滞剂、可乐定和苯妥英钠等药物可作为苯二氮䓬类药物的辅助用药。酒精戒断治疗之后应进行酒精依赖治疗。
