Alcohol Withdrawal

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Updated: 
February 15, 2024

Benzodiazepines (e.g., Diazepam, Lorazepam, Chlordiazepoxide):

  • Diazepam:**
  • 10-20 mg orally or intravenously every 1-2 hours as needed for severe symptoms.
  • Maintenance doses range from 10-40 mg/day in divided doses.
  • Lorazepam:**
  • 2-4 mg orally every 1-2 hours as needed for severe symptoms.
  • Maintenance doses range from 6-12 mg/day in divided doses.
  • Chlordiazepoxide:**
  • 25-100 mg orally every 1-2 hours as needed for severe symptoms.
  • Maintenance doses range from 50-300 mg/day in divided doses.

Anticonvulsants (e.g., Carbamazepine, Valproate):

  • Carbamazepine:
  • Loading dose of 200 mg orally every 6 hours on day 1, followed by maintenance doses of 200-400 mg orally every 6-8 hours.
  • Valproate:
  • Loading dose of 20-30 mg/kg/day orally in divided doses on day 1, followed by maintenance doses of 20-30 mg/kg/day.

Beta-Blockers (e.g., Propranolol):

  • Propranolol:
  • 20-40 mg orally every 6-8 hours as needed for tremors, palpitations, or tachycardia.

Alpha-2 Agonists (e.g., Clonidine):

  • Clonidine:
  • 0.1-0.3 mg orally every 4-6 hours as needed for symptoms of autonomic hyperactivity.

Thiamine (Vitamin B1):

  • Thiamine:
  • 100 mg intramuscularly or intravenously daily for several days to prevent Wernicke-Korsakoff syndrome, especially in chronic alcoholics.

Multivitamins and Electrolyte Supplements:

  • Multivitamins:
  • To replenish essential vitamins and minerals
  • ​Electrolyte supplements:
  • To correct any electrolyte imbalances caused by excessive alcohol consumption.

Other:

  • Gabapentin:
  • 300-600 mg orally three times a day to reduce alcohol cravings and certain withdrawal symptoms.