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- DOI 10.18231/j.ijpp.67971.1758779418
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Exploring alcohol withdrawal and therapeutic strategies in a tertiary teaching hospital in Nagapattinam
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.
References
- Sachdeva A, Kumar V, Rizvi SAA, Khullar S, Abidi SSA, Das A. Pattern of alcohol withdrawal syndrome and its clinical correlates. Biomedicine. 2021;41(2):278–82.
- Arokiadoss JD, Venkateshan N, Pauline D, Karthika, Niranjana BS. Predictors for severe alcohol withdrawal syndrome in clinical practice. Indian J Pharm Pract. 2025;18(2):155–60.
- Saitz R. Introduction to alcohol withdrawal. Alcohol Health Res World. 1998;22(1):5–12.
- Mirijello A, D’Angelo C, Ferrulli A, Vassallo G, Antonelli M, Caputo F, et al. Identification and management of alcohol withdrawal syndrome. Drugs. 2015;75(4):353–65.
- Vijayanand D, Dedeepya SD, Lavanya L. A retrospective study of symptom profile of psychiatric complications in alcohol dependence patients admitted in psychiatric ward in Chennai. J Evid Based Med Healthc. 2021;8(31):2842–7.
- Nagda P, Harshe D, Halder A, Ravindran NP. Study of socio-economic, biochemical and clinical predictors of alcohol withdrawal and delirium tremens in patients of alcohol dependence in Indian population. Annals Indian Psychiatry. 2024;8(1):52–60. Thirunanamoorthy et al. / Indian Journal of Pharmacy and Pharmacology 2025;12(3):137–143 143
- Abdulfattah O, Rahman EU, Alnafoosi Z, Schmidt F. Severe hypokalemia with cardiac arrest as an unusual manifestation of alcoholism. J Commun Hosp Intern Med Perspect. 2018;8(5): 285–91.
- Borah AJ, Deka K, Bhattacharyya K. Serum electrolytes and hepatic enzymes level in alcohol withdrawal patients with and without delirium tremens: a comparative study. Int J Health Sci Res. 2017;7(11):74–83.
- Gedam SR, Dhabarde A, Patil PS, Sharma A, Kumar K, Babar V. Psychiatric comorbidity, severity of dependence and liver enzymes dysfunction among alcohol dependent individuals: a cross-sectional study from central rural India. J Clin Diagn Res. 2019;13(4):1–5.
- Nagda P, Harshe D, Halder A, Ravindran NP. Study of socio- economic, biochemical and clinical predictors of alcohol withdrawal and delirium tremens in patients of alcohol dependence in Indian population. Ann Indian Psychiatry. 2024;8(1):52–60.
- Vignesh BT, Singh AK, Mohan SK, Murthy S, Joshi A. Association between socio-demographics and alcohol dependence among individuals living in an Indian setting. Glob J Health Sci. 2014;6(3):16–26.
- Sundaram DM, Madesh VP, Reddy DR, Baliga K. Multiple dyselectrolytemia in a chronic alcohol abuser: a case report. Cureus. 2023;15(3):e36389.
- Lohr RH. Treatment of alcohol withdrawal in hospitalized patients. Mayo Clin Proc. 1995;70(8):777–82.
- Mayo-Smith MF. Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. American society of addiction medicine working group on pharmacological management of alcohol withdrawal. JAMA. 1997;278(2):144–51.
- Yanta JH, Swartzentruber GS, Pizon AF. Alcohol withdrawal syndrome: improving outcomes through early identification and aggressive treatment strategies. Emerg Med Pract. 2015;17(6):1–18.
- Daeppen JB, Gache P, Landry U, Sekera E, Schweizer V, Gloor S, et al. Symptom-triggered vs fixed-schedule doses of benzodiazepine for alcohol withdrawal: a randomized treatment trial. Arch Intern Med. 2002;162(10):1117–21.
- The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management. J Addict. Med. 2020;14(3):1–72.
How to Cite This Article
Vancouver
Thirunanamoorthy R, Sundaram LS, Sekar V, Vaithiyanathan V, Balamurugan V. Exploring alcohol withdrawal and therapeutic strategies in a tertiary teaching hospital in Nagapattinam [Internet]. Indian J Pharm Pharmacol. 2025 [cited 2025 Oct 20];12(3):137-143. Available from: https://doi.org/10.18231/j.ijpp.67971.1758779418
APA
Thirunanamoorthy, R., Sundaram, L. S., Sekar, V., Vaithiyanathan, V., Balamurugan, V. (2025). Exploring alcohol withdrawal and therapeutic strategies in a tertiary teaching hospital in Nagapattinam. Indian J Pharm Pharmacol, 12(3), 137-143. https://doi.org/10.18231/j.ijpp.67971.1758779418
MLA
Thirunanamoorthy, Rengaraj, Sundaram, Lakshmi Sabapathi, Sekar, Vignesh, Vaithiyanathan, Vignesh, Balamurugan, Vilvarajeshwaran. "Exploring alcohol withdrawal and therapeutic strategies in a tertiary teaching hospital in Nagapattinam." Indian J Pharm Pharmacol, vol. 12, no. 3, 2025, pp. 137-143. https://doi.org/10.18231/j.ijpp.67971.1758779418
Chicago
Thirunanamoorthy, R., Sundaram, L. S., Sekar, V., Vaithiyanathan, V., Balamurugan, V.. "Exploring alcohol withdrawal and therapeutic strategies in a tertiary teaching hospital in Nagapattinam." Indian J Pharm Pharmacol 12, no. 3 (2025): 137-143. https://doi.org/10.18231/j.ijpp.67971.1758779418