Abstract

Alcohol abuse is one of the leading health risks in Estonia that burdens healthcare and economy. The alcohol withdrawal syndrome presents as a set of symptoms with varying severity that occur after a total or partial reduction in alcohol consumption following a period of regular or excessive use. The cause of withdrawal symptoms is hyperactivity of the central nervous system (mainly GABA and glutamate imbalances). Unless delirium tremens (DT) symptoms are adequately controlled with more than 50 mg of diazepam or 10 mg of lorazepam within the first hour of treatment, or intravenous infusion of 200 mg of diazepam or 40 mg of lorazepam within the first 3–4 hours of treatment, treatment refractory alcohol withdrawal may develop. Treatment guidelines on alcohol withdrawal include supportive care and psychomotor agitation management with benzodiazepines. Various drugs have been investigated for treating refractory DT, the most effective being phenobarbital, propofol and dexmedetomidine.