Treatment of alcohol withdrawal: A fixed schedule regimen versus symptom-triggered regimen

Objective: This study is to compare the efficacy of two treatment regimens of alcohol withdrawal syndrome, fixed schedule and symptom-triggered. Method: Sixty-two cases of alcohol withdrawal patients admitted to a psychiatric hospital during September 1997 to February 1998 were allocated to two groups. The first group (N = 32) was assessed the withdrawal severity with the Clinical Institute Withdrawal Assessment for Alcohol revised (CIWA-Ar) by nurse staff and received chlordiazepoxide according to the severity so called symptom-triggered regimen. The second group received medications in a fixed schedule fashion. The outcome measures were total chlordiazepoxide equivalent dose in mg. and duration of symptom after starting treatment and number of cases with complication. Result: The group treated with symptom-triggered regimen received less dose of chlordiazepoxide, improved faster and experienced less complications than another group with fixed schedule regimen. Conclusion: Treatment of alcohol withdrawal syndrome with symptom-triggered regimen is superior to fixed schedule regimen. The use of structured assessment scale, i.e. CIWA-Ar, with the symptom-triggered therapy is recommended as a standard treatment guideline for alcohol withdrawal syndrome.