Exploring alcohol withdrawal and therapeutic strategies in a tertiary teaching hospital in Nagapattinam

• Author Details:   
• Rengaraj Thirunanamoorthy
• Lakshmi Sabapathi Sundaram
• Vignesh Sekar
• Vignesh Vaithiyanathan ^*
• Vilvarajeshwaran Balamurugan

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Background: Alcohol Withdrawal Syndrome (AWS) is a potentially life-threatening condition that occurs following the sudden cessation of chronic alcohol use. Early identification and symptom-based management are essential to prevent complications such as seizures and delirium tremens.
Objectives: To evaluate the severity of AWS using the CIWA-Ar scale, assess associated clinical and biochemical abnormalities, and examine the therapeutic strategies employed in a tertiary care hospital.
Materials and Methods: A prospective observational study was conducted over six months in the general medicine ward at Government Medical College Hospital, Nagapattinam. A total of 150 male patients diagnosed with AWS were assessed using the CIWA-Ar scale. Laboratory investigations were carried out, and treatment regimens were documented.
Results: Among 150 patients, 77.3% experienced moderate withdrawal symptoms, 21.3% had mild symptoms, and 1.3% presented with severe symptoms. Common symptoms included nausea, sweating, tremors, and anxiety, with agitation and tactile disturbances associated with greater severity. Frequently observed biochemical abnormalities included hyponatremia (12.6%), hypokalaemia (11.3%), and elevated liver enzymes. Benzodiazepines, particularly diazepam (68.6%) and lorazepam (18%), were the primary treatments, alongside thiamine supplementation and supportive care. A significant positive correlation was found between the time since last alcohol intake and symptom severity.
Conclusion: Use of the CIWA-Ar scale facilitates timely, effective treatment in AWS. Structured protocols that include symptom-based pharmacotherapy and correction of biochemical imbalances can improve patient outcomes in tertiary care settings.