Phenobarbital versus diazepam for delirium tremens - a retrospective study.
Summary of "Phenobarbital versus diazepam for delirium tremens - a retrospective study."
INTRODUCTION:
Delirium tremens (DT) is a severe and potentially fatal condition that may occur during withdrawal from chronic alcohol intoxication. The purpose of the present study was to compare the effects and the rates of complications of phenobarbital and diazepam treatment in DT. MATERIAL AND
METHODS:
Data were collected retrospectively from the medical files of patients who had received DT treatment (n = 194) at two psychiatric departments located in the general Copenhagen area in the 1998-2006 period. At one department, all patients were treated with phenobarbital (n = 53), while the treatment regimen at the other department was changed from phenobarbital (n = 53) to diazepam (n = 88) in 2002.
RESULTS:
Length of DT and hospitalization, mortality and rate of pneumonia (26%) were not affected by treatment. A subpopulation (9%) in the diazepam group was resistant to treatment. Respiratory depression occurred in 4% of the phenobarbital and in 1% of the diazepam-treated patients. Wernicke's encephalopathy was established in 47% of the patients.
CONCLUSION:
Phenobarbital is a safe alternative to diazepam in the treatment of DT.
Affiliation
Ulrichsens Klinik Psykiatri, Nørre Voldgade 11, 3. sal, 1358 København K, Denmark. jakobulrichsen@mac.com.
Journal Details
This article was published in the following journal.
Name: Danish medical bulletin
ISSN: 1603-9629
Pages: A4169
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20682133
- DOI: http://dx.doi.org/
Medical and Biotech [MESH] Definitions
Alcohol Withdrawal Delirium
An acute organic mental disorder induced by cessation or reduction in chronic alcohol consumption. Clinical characteristics include CONFUSION; DELUSIONS; vivid HALLUCINATIONS; TREMOR; agitation; insomnia; and signs of autonomic hyperactivity (e.g., elevated blood pressure and heart rate, dilated pupils, and diaphoresis). This condition may occasionally be fatal. It was formerly called delirium tremens. (From Adams et al., Principles of Neurology, 6th ed, p1175)
Nordazepam
An intermediate in the metabolism of DIAZEPAM to OXAZEPAM. It may have actions similar to those of diazepam.
Mephobarbital
A barbiturate that is metabolized to PHENOBARBITAL. It has been used for similar purposes, especially in EPILEPSY, but there is no evidence mephobarbital offers any advantage over PHENOBARBITAL.
Retrospective Studies
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Primidone
An antiepileptic agent related to the barbiturates; it is partly metabolized to PHENOBARBITAL in the body and owes some of its actions to this metabolite. Adverse effects are reported to be more frequent than with PHENOBARBITAL. (From Martindale, The Extra Pharmacopoeia, 30th ed, p309)
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