Withdrawal from heavy and prolonged use of alcohol can be dangerous and should be done under medical supervision. According to the University of Maryland Medical Center, symptoms of withdrawal usually appear within six to 48 hours after the last drink, with the peak at about 24 to 35 hours. Common withdrawal symptoms are insomnia, anxiety, irritability and agitation. More serious symptoms include aggression, fever, blood pressure changes, rapid heartbeat or arrhythmia, seizures and delirium tremens, which includes hallucinations. About 10 percent of people going through withdrawal experience seizures and 60 percent of those can have multiple seizures.
Causes of Withdrawal Symptoms
According to Aetna InteliHealth, when a person consumes a large quantity of alcohol over prolonged periods of time, the brain produces larger quantities of stimulating chemicals such as serotonin and norepinephrine. It does this to compensate for the depressant effect of alcohol. When the alcohol is stopped suddenly, it takes time for the brain to readjust, and the brain is overstimulated. This results in withdrawal symptoms. Because withdrawal can be life-threatening, severe alcoholics should be treated in hospitals or detox facilities.
Medications
The goal is to prevent seizures and other serious withdrawal symptoms before they start. The University of Maryland Medical Center advises benzodiazepines are the accepted treatment for a person going through alcohol withdrawal. Benzodiazepines inhibit nerve-cell excitability which counteracts the overstimulation resulting from the brain being deprived of the depressant effect of alcohol. Examples of benzodiazepines that may be used are chlordiazepoxide, oxazepam, halazepam, diazepam, alprazolam and lorazepam.
According to the American Academy of Family Physicians, a typical treatment plan involves a loading dose of a long-acting benzodiazepine, followed by a schedule of tapering doses. This regimen supports the patient through the alcohol withdrawal stage but avoids the development of benzodiazepine dependence.
If seizures occurs, the University of Maryland Medical Center advises most are self-limiting. However, if the person has a history of seizures or the seizures do not stop, doctors can administer intravenous phenytoin, an antiseizure medication, along with a benzodiazepine. While antiseizure medications used alone will not prevent seizures, they can allow a physician to give a lower dose of benzodiazepine.
Supportive Treatment
Vital signs should be monitored during withdrawal. Because alcohol abusers generally are deficient in several vitamins and minerals, supplements may be given. Aetna InteliHealth advises shortages of folate, vitamin B12 and thiamine are common. Magnesium, zinc and phosphate deficiencies may also exist. Blood sugar can be a concern during withdrawal and may need to be monitored.
