Thompson W L
Arch Intern Med. 1978 Feb;138(2):278-83.
Withdrawal from alcohol (ethanol, ethyl alcohol) or other general sedatives leads to progressive hyperactivity that progresses from tremulousness, sleep disturbance, and hallucinosis, to the more serious rum fits and delirium tremens (DTs). Withdrawal can be prevented and, in most cases, arrested by prompt replacement of alcohol with paraldehyde, benzodiazepines or other general sedatives. Diazepam is appropriate replacement therapy for most patients. When delirium is manifest, the chance is greater than 15% that the patient will die, and this reaction cannot be aborted. The patient with DTs must be calmed with a general sedative that has a rapid onset of maximal effect to prevent overdosage. Diazepam, 5 mg intravenously every five minutes, permits evaluation of the maximal effect of each dose before the next dose is administered. Although some patients have advance sedative or alcohol withdrawal, great care must be taken to elicit the proper history of alcohol abuse so that sedative replacement therapy will prevent or abort early withdrawal, thus sparing the patient a mortality equivalent to that of acute myocardial infarction or Russian roulette.
停止饮酒（乙醇、酒精）或其他全身性镇静剂会导致进行性多动，起初表现为震颤、睡眠障碍和幻觉，进而发展为更严重的癫痫发作和震颤谵妄（DTs）。可以通过及时用副醛、苯二氮卓类药物或其他全身性镇静剂替代酒精来预防戒断反应，在大多数情况下还能终止戒断反应。地西泮是大多数患者合适的替代疗法。当出现谵妄时，患者死亡几率超过15%，且这种反应无法中止。患有震颤谵妄的患者必须使用起效迅速且能达到最大效果的全身性镇静剂来使其平静，以防止用药过量。每五分钟静脉注射5毫克地西泮，这样在下一剂给药前可评估每一剂的最大效果。尽管有些患者会提前出现镇静剂或酒精戒断反应，但必须格外谨慎地了解其酒精滥用的准确病史，以便镇静剂替代疗法能预防或终止早期戒断反应，从而使患者免于相当于急性心肌梗死或俄罗斯轮盘赌般的死亡率。
