From the Guidelines
Treatment of Tachycardia in Alcohol Withdrawal Syndrome
The treatment of tachycardia in alcohol withdrawal typically involves the administration of benzodiazepines to reduce sympathetic nervous system activity and alleviate withdrawal symptoms 1.
- Benzodiazepines such as lorazepam (1-2 mg orally or intravenously every 4-6 hours) or diazepam (5-10 mg orally or intravenously every 4-6 hours) are commonly used 1.
- In cases where tachycardia is severe or persistent, beta blockers like propranolol (10-20 mg orally every 4-6 hours) or atenolol (25-50 mg orally every 12 hours) may be added to control heart rate.
- The duration of treatment is usually tailored to the individual's withdrawal severity and typically ranges from 3 to 14 days.
- It is also recommended to prescribe thiamine as part of the withdrawal process to prevent the onset of Wernicke's encephalopathy, especially since thiamine deficiency is common in alcohol-dependent individuals 1.
- For patients with liver disease, particularly those with decompensated liver disease, a personalized prescription that is symptom-adapted and favors short-acting drugs like lorazepam or oxazepam is recommended to avoid drug accumulation and the risk of encephalopathy 1.
From the FDA Drug Label
As an aid in symptomatic relief of acute agitation, tremor, impending or acute delirium tremens and hallucinosis. 10 mg, intramuscular or intravenous initially, then 5 mg to 10 mg in 3 to 4 hours, if necessary. The treatment for tachycardia in alcohol (ethanol) withdrawal syndrome is not directly addressed, however, diazepam may be useful in the symptomatic relief of acute agitation, tremor, impending or acute delirium tremens and hallucinosis in acute alcohol withdrawal.
- The recommended dose is 10 mg, intramuscular or intravenous initially, then 5 mg to 10 mg in 3 to 4 hours, if necessary 2.
- Diazepam is indicated for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety, including acute alcohol withdrawal 2.
From the Research
Treatment for Tachycardia in Alcohol Withdrawal Syndrome
- Tachycardia is a common symptom associated with alcohol withdrawal syndrome, and its treatment is crucial to prevent further complications.
- According to 3, beta blockers are useful in combating hypertension and tachycardia commonly associated with alcohol withdrawal.
- Benzodiazepines are the preferred treatment for alcohol withdrawal syndrome, including tachycardia, due to their high efficacy and safety record 3, 4, 5, 6.
- The use of benzodiazepines, such as diazepam, can help alleviate symptoms of alcohol withdrawal, including tachycardia, and prevent the development of more severe symptoms like seizures and delirium tremens 4, 7, 6.
- Other medications, such as clonidine, may also be useful in treating tachycardia and other symptoms associated with alcohol withdrawal 3.
- The treatment approach may vary depending on the severity of the withdrawal symptoms and the patient's medical history, and careful clinical assessment is essential to determine the best course of treatment 3, 6.