38
Flowcharts
Pharmacotherapy
BZD
Risk of severe,
complicated, OR
complications of
withdrawal
At least one
dose of BZD
Withdrawal
severity?
High None Low/Moderate
PB if BZD
contraindicated
Continue
prophylaxis
during acute
risk window
BZD
PB if BZD
contraindicated
CAB, GAB also
appropriate
Setting?
BZD, CAR,
GAB, or
No Rx
Severe/Complicated
(CIWA-Ar ≥19)
Mild
(CIWA-Ar
<10)
BZD, CAR,
GAB
CAR, GAB,
No Rx
Monitor
frequently over
next 24 hrs
Unknown
YES NO
BZD
Moderate
(CIWA-Ar 10-18)
Ambulatory Inpatient
Risk of
symptoms
worsening?
BZD, benzodiazepine; CAB, carbamazepine; GAB, gabapentin;
No Rx, no medication (supportive care alone), PB, phenobarbital