TY - JOUR
T1 - Impact of Adjuvant Anticonvulsant Medications on Benzodiazepine Use and Delirium in Alcohol Withdrawal Syndrome
AU - Fargahi, Farshid
AU - Shrestha, Ritesh
AU - Rawal, Himanshu
AU - Jaar, Bernard G.
AU - Chilipko, Allison A.
AU - Norwood, Daryn K.
AU - Ji, Christine
AU - Yazaji, Eskandar Alex
N1 - Funding Information:
Internal institutional funding from Graduate Medical Education (GME) MedStar Health, MedStar Union Memorial Hospital. The authors thank Sameer Desale, MS, and Mihriye Mete, PhD, of MedStar Health Research Institute, Baltimore, Maryland, for statistical support and Lyn Camire, MA, ELS, of MedStar Union Memorial Hospital, Baltimore, Maryland, for editorial assistance. Mr Desale, Dr Mete, and Ms Camire report no conflicts of interest related to the subject of this article.
Publisher Copyright:
© 2021 Physicians Postgraduate Press, Inc.
PY - 2021
Y1 - 2021
N2 - Objective: To assess the benefits of anticonvulsant medications on benzodiazepine (BZD) use and delirium in patients with alcohol dependence at risk of alcohol withdrawal and admitted to the hospital without delirium. Methods: This was a resident-led retrospective study of prospectively collected data for patients admitted to the monitored unit of a general medical ward between June 2016 and March 2017 for a variety of medical conditions. Patients were assigned to the usual care group (BZD as needed) or the intervention group (scheduled anticonvulsants and BZD as needed) based on admission census and order of arrival. Of 75 patients, 44 were assigned to the usual care group and 31 to the intervention group. Results: Significantly lower BZD dosage (P = .0002) and lower Clinical Institute Withdrawal Assessment for Alcohol Scale-Revised scores were observed in the intervention group. Delirium occurred significantly less in the intervention group (0 versus 7 in the usual care group; P = .037). Conclusions: Adjuvant anticonvulsant medications for alcohol withdrawal were efficacious in reducing BZD use, severity of symptoms of alcohol withdrawal, and occurrence of delirium in patients admitted to the general medical ward without delirium for reasons other than alcohol detoxification.
AB - Objective: To assess the benefits of anticonvulsant medications on benzodiazepine (BZD) use and delirium in patients with alcohol dependence at risk of alcohol withdrawal and admitted to the hospital without delirium. Methods: This was a resident-led retrospective study of prospectively collected data for patients admitted to the monitored unit of a general medical ward between June 2016 and March 2017 for a variety of medical conditions. Patients were assigned to the usual care group (BZD as needed) or the intervention group (scheduled anticonvulsants and BZD as needed) based on admission census and order of arrival. Of 75 patients, 44 were assigned to the usual care group and 31 to the intervention group. Results: Significantly lower BZD dosage (P = .0002) and lower Clinical Institute Withdrawal Assessment for Alcohol Scale-Revised scores were observed in the intervention group. Delirium occurred significantly less in the intervention group (0 versus 7 in the usual care group; P = .037). Conclusions: Adjuvant anticonvulsant medications for alcohol withdrawal were efficacious in reducing BZD use, severity of symptoms of alcohol withdrawal, and occurrence of delirium in patients admitted to the general medical ward without delirium for reasons other than alcohol detoxification.
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U2 - 10.4088/PCC.20m02860
DO - 10.4088/PCC.20m02860
M3 - Article
C2 - 34674404
AN - SCOPUS:85120583906
SN - 1523-5998
VL - 23
JO - The primary care companion for CNS disorders
JF - The primary care companion for CNS disorders
IS - 5
M1 - 20m02860
ER -