ASAM Pocket Guidelines and Patient Guide

Alcohol Withdrawal Management

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26 Treatment – Inpatient (7) A2AAs and beta-blockers Î Recommendation V.36: Alpha2-adrenergic agonists (AA2s) such as clonidine and dexmedetomidine can be used as an adjunct to benzodiazepine therapy to control autonomic hyperactivity and anxiety when these signs are not controlled by benzodiazepines alone. They should not be used alone to prevent or treat withdrawal-related seizures or delirium. Î Recommendation V.37: Beta-adrenergic antagonists (beta-blockers) can be used as an adjunct to benzodiazepines in select patients for control of persistent hypertension or tachycardia when these signs are not controlled by benzodiazepines alone. They should not be used to prevent or treat alcohol withdrawal seizures. (8) Inappropriate medications Î Recommendation V.38: Oral or intravenous alcohol should not be used for the prevention or treatment of alcohol withdrawal. Î Recommendation V.39: There is insufficient evidence to support the use of baclofen for the treatment of alcohol withdrawal. Î Recommendation V.40: Providing magnesium as a prophylaxis or treatment for alcohol withdrawal management has no supporting evidence.

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