Expert opinion on management of alcohol withdrawal syndrome in India

Alcohol dependence is an escalating and pervasive problem worldwide. Alcohol withdrawal syndrome (AWS) is a distressing condition, occurring due to abrupt discontinuation of alcohol in alcohol dependents. It is a common management problem encountered in general hospital settings. The symptoms of AWS range from mild to severe. Proper diagnosis and choice of an appropriate drug regimen for AWS play a key role in effective management. Severe complicated alcohol withdrawal may present with hallucinations, seizures, or delirium tremens. Benzodiazepines (BZDs), considered as the gold standard, have the largest evidence base as treatment for alcohol withdrawal. Other management strategies include use of essential vitamins (as supportive care), anticonvulsants, barbiturates, adrenergic drugs, and gamma-aminobutyric acid (GABA) agonists. Chlordiazepoxide is an effective long-acting benzodiazepine agent and offers a slight advantage over other BZDs. The present review aims to provide an evidence-based consensus on management algorithm for AWS according to the Indian clinical scenario.