Pharmacological management of alcohol withdrawal : A meta-analysis and evidence-based practice guideline.
Objectlve. - To provide an evidence-based practice guideline on the pharmacological management of alcohol withdrawal.
- English-language articles published before July 1,1995, identified through MEDLINE search on « substance withdrawal-ethyl alcohol » and review of references from identified articles.
Study Selection-Articles with original data on human subjects.
- Structured review to determine study design, sample size, interventions used, and outcomes of withdrawal severity, delirium, seizures, completion of withdrawal, entry into rehabilitation, adverse effects, and costs.
Data from prospective controlled trials with methodologically sound end points corresponding to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, were abstracted by 2 independent reviewers and underwent meta-analysis.
- Benzodiazepines reduce withdrawal severity, reduce incidence of delirium (-4.9 cases per 100 patients ; 95% confidence interval, - 9.0 to - 0.7 ; P=04), and reduce seizures (-7.7 seizures per 100 patients ; 95% confidence interval, - 12.0 to - 3.5 ; P=003).
Individualizing therapy with withdrawal scales results in administration of significantly less medication and shorter treatment (P<. 001). bêta-Blockers, clonidine, and carbamazepine ameliorate withdrawal severity, but evidence is inadequate to determine their effect on delirium and seizures. (...)
Mots-clés Pascal : Alcoolisme, Sevrage syndrome, Prospective, Propriété pharmacologique, Métaanalyse, Facteur prédictif, Benzodiazépine dérivé, Indication, Article synthèse, Homme, Système nerveux pathologie, Métabolisme pathologie, Psychopathologie, Organisation santé, Activité biologique, Tranquillisant, Antidépresseur
Mots-clés Pascal anglais : Alcoholism, Withdrawal syndrome, Prospective, Pharmacological activity, Metaanalysis, Predictive factor, Benzodiazepine derivatives, Indication, Review, Human, Nervous system diseases, Metabolic diseases, Psychopathology, Public health organization, Biological activity, Tranquillizer, Antidepressant agent
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0381068
Code Inist : 002B02B02. Création : 12/09/1997.