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How Effective Is Diazepam for Alcohol Withdrawal?

By S. Berger
Updated: May 17, 2024

Alcohol withdrawal can be a dangerous, and even fatal, condition without proper treatment. Medical professionals often prescribe or administer diazepam for alcohol withdrawal because of the way that this medication works in the brain. Drinking heavily affects certain brain cells, called neurons, that become overstimulated when alcohol is no longer present. Diazepam affects these same neurons in a similar way to alcohol, but with less euphoria and potential for abuse. Affecting these neurons' receptors allows this medication to safely relieve many symptoms of alcohol withdrawal.

There are many factors that determine whether diazepam for alcohol withdrawal is the most effective treatment option. Drug abuse history is one such factor. Despite being less addictive than alcohol, this medication is abused by some. Patients with a history of abusing drugs aside from alcohol may therefore benefit from a different medication during withdrawal.

Seizures and convulsions are a major risk in severe cases of alcohol detoxification. A variety of anti-seizure medications could be used to treat these, but not all of them affect the same neurons as diazepam. For this reason, they are not always as effective at controlling seizures, and these other medications do not control other symptoms of withdrawal, either. Diazepam for alcohol withdrawal not only prevents life-threatening seizures, but controls most withdrawal features.

The dosage of diazepam for alcohol withdrawal can be increased depending on symptom severity. Unlike many medications that are used to treat this condition, diazepam is one of the most effective at treating high blood pressure, as well as delerium tremens, a withdrawal condition characterized by hallucinations and confusion. If an initial dose is not successful at calming down a patient with these symptoms, the dosage can be increased without adverse side effects for the patient. Not all medications have such a high margin of safety, making diazepam useful for these patients.

This drug's long half-life is another reason diazepam for alcohol withdrawal is often an effective choice. Some other sedatives must be given several times a day to control withdrawal symptoms and keep patients calm. Studies have shown that a single daily dose of 40 milligrams (mg) can treat symptoms as effectively as 20 mg chlordiazepate, a similar medication, given four times a day. Alcohol abuse can damage the liver, however, and this damage increases the time taken for drugs to leave a patient's body. In the event of liver damage, doctors tend to prefer administering medications like chlordiazepate or lorazepam, which work similar to diazepam, with shorter half-lives.

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