Alcohol withdrawal

Alcohol withdrawal is caused by the abrupt cessation of alcohol consumption in patients with alcohol dependence or chronic alcoholism.

The clinical presentation consists of a spectrum of signs and symptoms, including autonomic hyperactivity, tremulousness, restlessness, through to seizures and potentially life-threatening delirium tremens.

Alcohol withdrawal syndrome is a clinical diagnosis.

Symptom-triggered therapy with benzodiazepines remains the cornerstone of management.

Alcohol withdrawal syndrome (AWS), commonly referred to as "the shakes," occurs in patients with alcohol dependence when their daily alcohol consumption is decreased or stopped. The decrease in blood ethanol below the level at which the patient is habituated triggers AWS. The syndrome typically begins within 4 to 12 hours after the patient's last drink, and may progress to potentially fatal delirium tremens.[1]Isbell H, Fraser HF, Wikler A, et al. An experimental study of the etiology of rum fits and delirium tremens. Q J Stud Alcohol. 1955 Mar;16(1):1-33. http://www.ncbi.nlm.nih.gov/pubmed/14372008?tool=bestpractice.com [2]Victor M, Adams RD. The effect of alcohol on the nervous system. Res Publ Assoc Res Nerv Ment Dis. 1953;32:526-73. http://www.ncbi.nlm.nih.gov/pubmed/13134661?tool=bestpractice.com