GuidelinesPrimary Care STG
Alcohol Withdrawal (Uncomplicated)
Description General measures Medicine treatment Referral ICD-10 code: F10.3 Description A syndrome characterised by central nervous system hyperactivity that occurs when an alcohol dependent individual abruptly stops, or significantly reduces, alcohol consumption. The symptoms of complicated alcohol withdrawal syndrome, requiring referral, include: Autonomic: sweating, tachycardia, hypertension,
ICD-10 code: F10.3
Description
- A syndrome characterised by central nervous system hyperactivity that occurs when an alcohol dependent individual abruptly stops, or significantly reduces, alcohol consumption.
- The symptoms of complicated alcohol withdrawal syndrome, requiring referral, include:
- Autonomic: sweating, tachycardia, hypertension, tremors, tonic-clonic seizures, and low grade fever.
- Gastrointestinal: anorexia, nausea, vomiting, dyspepsia, and diarrhoea.
- Cognitive and perceptual disturbances: poor concentration, anxiety, psychomotor agitation, disturbed sleep with vivid dreams, visual hallucinations, and disorientation.
- Typical delirium occurs 2–3 days following cessation of prolonged alcohol intake, but some withdrawal symptoms such as the typical tremor, may start within 12 hours.
General Measures
- Assess for comorbid infections.
Medicine Treatment
- Thiamine, oral, 300 mg daily for 14 days.
AND
- Diazepam, oral, 10 mg immediately. (Doctor prescribed)
- Then 5 mg 6 hourly for 3 days.
- Then 5 mg 12 hourly for 2 days.
- Then 5 mg daily for 2 days.
- Then stop.
Referral
- See: referral criteria of Substance use disorders.
- Complicated alcohol withdrawal, including persistent seizures despite oral benzodiazepine therapy.
Standard Treatment Guidelines and Essential Medicines List for South Africa Primary Healthcare Level_Chapter 16: Mental Health Conditions_NEMLC Recommendations for Medicine Amendments 2020_2023