Dr. Wasser's Instructions For Persons Undergoing Alcohol Detox  

Return To Substance Abuse Articles

The chronic use of alcohol causes abnormalities in the ways our body and brain work.  Alcohol withdrawal refers to the physical and emotional symptoms we experience as alcohol leaves our body and these abnormalities reverse.  Alcohol withdrawal usually begins 6-12 hours after the last drink, peaks at 1-2 days and then resolves in 3-5 days.  Most people will experience tremulousness, anxiety, flushing, palpitations and high blood pressure.  In severe cases, confusion can set in as well as hallucinations; these are serious complications that need to be discussed immediately with the doctor.  Seizures may also occur infrequently but are not a real problem unless they are multiple.  A frequent problem, especially in people who are older and with long-term use, is ataxia.  This refers to a worsening of coordination and balance that may take up to a week to resolve.  In severe cases, this may not completely resolve.  Certain medications may transiently worsen this condition.

 A person undergoing withdrawal should not be alone for the first 48-72 hours.  Liquid intake is to be strongly encouraged. .  Small frequent bland meals are also appropriate.

 Below are the medications I frequently use in treatment

1-Depakote (valproic acid) - This is an anti-seizure medication that has been shown to reduce the intensity of alcohol withdrawal.  It is taken for five days.  Some patients develop intestinal symptoms and a few others develop vague neurological symptoms but the majority of patients tolerate the medication well.  At times, I may also substitute other similar medications such as gabapentin or carbamazepam.

2-Lopressor (atenolol) - This is a blood pressure and heart medication that is able to reduce blood pressure, palpitations and tremulousness associated with the withdrawal.  It is used for five days.  It may be associated with excessive lowering of the pressure and lightheadedness.

3-Librium-This medicine is a central nervous system depressant that helps withdrawal; however, it can cause excessive sedation and worsen discoordination. 

4-Vitamins- These are very important secondary to vitamin and mineral depletion that is often seen.  Supplemental vitamin B1 (Thiamine) is most important to replenish (at least 100 mgs. daily during the detox process) as well as folate, and magnesium.

5-Clonidine-This medicine is occasionally used instead of Lopressor. 

6-Immodeum-Many people note severe diarrhea (due to alcohol toxicity as well as withdrawal) This over the counter medication brings significant relief.

7-Zofran - This is an anti-nausea medication that is occasionally used.

Return to Substance Abuse Articles

Schedule an Appointment