The treatment for alcohol withdrawal is a benzodiazepine. I honestly don’t think the benzo you choose matters that much. I use diazepam because its maximal effect intravenously is seen at about 5 minutes, so it is easily and safely titrated and its long half life provides some degree of auto-taper. My first dose is 10mg, and this dose is repeated once at 5 minutes if response is not adequate. (It won’t be in this patient.) I then double the dose to 20mg and continue with 20mg, 30mg, 30mg, 40mg, then 40mg every 5 minutes as needed...
Other FOAMed Resources
- EMCrit Podcast 11 – Delirium Tremens
- Phenobarbital monotherapy for alcohol withdrawal: Simplicity and power on PulmCrit
- CIWA-Ar for Alcohol Withdrawal on MDCalc