2024
A detox dilemma beyond benzodiazepines; clonidine's quandary in alcohol withdrawal management
Johnson M, Cosentino D, Fuehrlein B. A detox dilemma beyond benzodiazepines; clonidine's quandary in alcohol withdrawal management. American Journal On Addictions 2024, 34: 101-103. PMID: 39096168, DOI: 10.1111/ajad.13640.Peer-Reviewed Original ResearchPsychiatric emergency roomAlcohol withdrawalBenzodiazepine useAmerican Society of Addiction Medicine guidelinesTreatment of alcohol withdrawalClinical Institute Withdrawal AssessmentAWS managementAlternative agentsComorbid hypertensionEmergency roomVeterans AffairsRetrospective chart reviewWithdrawal AssessmentOpioid withdrawalBenzodiazepine doseAdjunctive medicationsAlcohol withdrawal managementBenzodiazepinesWithdrawal managementDepartment of Veterans AffairsVeteran populationClonidine useMedication dosesChart reviewSyndromic managementMedications for alcohol‐use disorder and follow‐up after hospitalization for alcohol withdrawal: A multicenter study
Allaudeen N, Akwe J, Arundel C, Boggan J, Caldwell P, Cornia P, Cyr J, Ehlers E, Elzweig J, Godwin P, Gordon K, Guidry M, Gutierrez J, Heppe D, Hoegh M, Jagannath A, Kaboli P, Krug M, Laudate J, Mitchell C, Pescetto M, Rodwin B, Ronan M, Rose R, Shah M, Smeraglio A, Trubitt M, Tuck M, Vargas J, Yarbrough P, Gunderson C. Medications for alcohol‐use disorder and follow‐up after hospitalization for alcohol withdrawal: A multicenter study. Journal Of Hospital Medicine 2024, 19: 1122-1130. PMID: 39031461, DOI: 10.1002/jhm.13458.Peer-Reviewed Original ResearchAlcohol-use disordersResidential treatment programAlcohol withdrawalFollow-up appointmentsImprove abstinenceAll-cause 30-day readmissionFollow-upTreatment programsReturn to heavy drinkingAssociated with improved outcomesRetrospective cohort studyOutpatient follow-upEffects of medicationAssociated with readmissionTime of dischargeVeterans Health Administration hospitalsAssociated with decreased readmissionMulticenter studyAcute care hospitalsAssociated with reduced 30-day readmissionsResidential programsPrescription of medicationsAbstinenceCohort studyHeavy drinkingContemporary Management and Outcomes of Veterans Hospitalized With Alcohol Withdrawal: A Multicenter Retrospective Cohort Study
Ronan M, Gordon K, Skanderson M, Krug M, Godwin P, Heppe D, Hoegh M, Boggan J, Gutierrez J, Kaboli P, Pescetto M, Guidry M, Caldwell P, Mitchell C, Ehlers E, Allaudeen N, Cyr J, Smeraglio A, Yarbrough P, Rose R, Jagannath A, Vargas J, Cornia P, Shah M, Tuck M, Arundel C, Laudate J, Elzweig J, Rodwin B, Akwe J, Trubitt M, Gunderson C. Contemporary Management and Outcomes of Veterans Hospitalized With Alcohol Withdrawal: A Multicenter Retrospective Cohort Study. Journal Of Addiction Medicine 2024, 18: 389-396. PMID: 38452185, DOI: 10.1097/adm.0000000000001297.Peer-Reviewed Original ResearchSymptom-triggered therapyRetrospective cohort studyTreatment durationComplicated withdrawalVeterans Health AdministrationAlcohol withdrawalFixed doseFactors associated with treatment durationCohort studyMulticenter retrospective cohort studyFixed-dose regimensLong-acting benzodiazepinesVeterans Health Administration Corporate Data WarehouseShort-acting benzodiazepineAmerican Society of Addiction Medicine (ASAMAlcohol withdrawal managementChart reviewHealth care systemCorporate Data WarehouseOutcomes of veteransInpatient managementTherapyWithdrawal managementHospital outcomesManagement pathway
2023
Phencyclidine Positivity on Urine Drug Screening in Patients Treated for Alcohol Withdrawal on a Dual-diagnosis Medically Assisted Withdrawal Unit
Wang P, Dore S, Weleff J, Butler R, Barnett B. Phencyclidine Positivity on Urine Drug Screening in Patients Treated for Alcohol Withdrawal on a Dual-diagnosis Medically Assisted Withdrawal Unit. Journal Of Addiction Medicine 2023, 17: 695-701. PMID: 37934534, DOI: 10.1097/adm.0000000000001217.Peer-Reviewed Original ResearchConceptsAlcohol withdrawalLength of stayPCP-positiveDual diagnosisMultivariate logistic regressionAlcohol use disorderRisk of readmissionToxicological screeningLogistic regressionRetrospective study of patientsSurvival analysisUrine drug screensUrine toxicology screenWithdrawing unitUse disorderAdmission toxicology screeningStudy of patientsCocaine positivityStatistically significant associationPhencyclidineMultivariate linear regression modelPCPRetrospective studyUnivariate testsCocaine
2022
Prevention of alcohol withdrawal syndrome in the surgical ICU: an American Association for the Surgery of Trauma Critical Care Committee Clinical Consensus Document
Seshadri A, Appelbaum R, Carmichael S, Farrell M, Filiberto D, Jawa R, Kodadek L, Mandell S, Miles M, Paul J, Robinson B, Michetti C. Prevention of alcohol withdrawal syndrome in the surgical ICU: an American Association for the Surgery of Trauma Critical Care Committee Clinical Consensus Document. Trauma Surgery & Acute Care Open 2022, 7: e001010. PMID: 36425749, PMCID: PMC9680182, DOI: 10.1136/tsaco-2022-001010.Peer-Reviewed Original ResearchClinical consensus documentAlcohol withdrawal syndromeSurgical ICUAlcohol withdrawalWithdrawal syndromeConsensus documentSurgical intensive care unit patientsIntensive care unit patientsCare unit patientsChallenging clinical entityCritical Care CommitteeAmerican AssociationUnit patientsClinical entityProphylactic treatmentPharmacological methodsCare CommitteeScreening toolICUSurgerySyndromeWithdrawalAssociationPatientsTraumaAlcohol withdrawal in past‐year drinkers with unhealthy alcohol use: Prevalence, characteristics, and correlates in a national epidemiologic survey
Livne O, Feinn R, Knox J, Hartwell EE, Gelernter J, Hasin DS, Kranzler HR. Alcohol withdrawal in past‐year drinkers with unhealthy alcohol use: Prevalence, characteristics, and correlates in a national epidemiologic survey. Alcohol Clinical And Experimental Research 2022, 46: 422-433. PMID: 35275407, PMCID: PMC8928097, DOI: 10.1111/acer.14781.Peer-Reviewed Original ResearchConceptsAlcohol withdrawal syndromeUnhealthy alcohol useSerious adverse outcomesNational Epidemiologic SurveyAlcohol useHealthcare utilizationAdverse outcomesGeneral populationPsychiatric disordersEpidemiologic SurveyAlcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnairePast-year alcohol use disorderNausea/vomitingMajor depressive disorderImportant clinical populationAlcohol use disorderRelated Conditions-IIIBorderline personality disorderPast-year prevalenceAlcohol withdrawalWithdrawal syndromeWithdrawal symptomsDepressive disorderUnhealthy drinkersHigher odds
2021
A Review of Phenobarbital for Alcohol Withdrawal Syndrome
Saadatmand H, Ho P. A Review of Phenobarbital for Alcohol Withdrawal Syndrome. Current Psychopharmacologye 2021, 10: 197-207. DOI: 10.2174/2211556010666210810094103.Peer-Reviewed Original ResearchAlcohol withdrawal syndromeAlcohol withdrawalIntensive care unitWithdrawal syndromeEmergency departmentCare unitIntensive care admission rateTrauma surgery serviceClasses of medicationsRetrospective cohort trialGeneral medical unitCommon clinical problemDose of phenobarbitalAlcohol use disorderSerious health problemCohort trialProspective randomizedClinical outcomesSurgery serviceCochrane DatabaseRetrospective trialsAdmission ratesInpatient settingOvid MEDLINESuperior efficacyEmergent and Non-Emergent Agitation in the Older Adult: Evaluation and Management
Subramanian S, Fahed M, Dix E, Wilkins K. Emergent and Non-Emergent Agitation in the Older Adult: Evaluation and Management. Current Geriatrics Reports 2021, 10: 73-81. DOI: 10.1007/s13670-021-00358-6.Peer-Reviewed Original ResearchCohen-Mansfield Agitation InventoryElectroconvulsive therapyOlder adultsPsychiatric disordersNon-pharmacological managementAlcohol withdrawalDistressing symptomsBenzodiazepine usePharmacological treatmentTreatment optionsExcited catatoniaHeterogenous presentationSuccessful treatmentSignificant disabilitySubstance intoxicationNeuropsychiatric conditionsMotor behaviorCognitive enhancersPolypharmacyAdultsDeliriumPatientsCatatoniaReviewThis paperTreatment
2019
Symptom-Triggered Therapy for Alcohol Withdrawal Syndrome: a Systematic Review and Meta-analysis of Randomized Controlled Trials
Holleck JL, Merchant N, Gunderson CG. Symptom-Triggered Therapy for Alcohol Withdrawal Syndrome: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Journal Of General Internal Medicine 2019, 34: 1018-1024. PMID: 30937668, PMCID: PMC6544709, DOI: 10.1007/s11606-019-04899-7.Peer-Reviewed Original ResearchConceptsSymptom-triggered therapyDuration of therapyAlcohol withdrawal syndromeBenzodiazepine doseWithdrawal syndromeTrial of patientsLow-risk patientsGeneral hospital settingRandomized Controlled TrialsRisk of biasTerms of mortalitySystematic literature searchStrength of evidenceBenzodiazepine dosageDose therapyMedication classesCochrane RegistryCochrane riskDose regimensAlcohol withdrawalBias toolControlled TrialsDose scheduleResultsSix studiesI2 statistic
2018
Risk Locus Identification Ties Alcohol Withdrawal Symptoms to SORCS2
Smith AH, Ovesen PL, Skeldal S, Yeo S, Jensen KP, Olsen D, Diazgranados N, Zhao H, Farrer LA, Goldman D, Glerup S, Kranzler HR, Nykjær A, Gelernter J. Risk Locus Identification Ties Alcohol Withdrawal Symptoms to SORCS2. Alcohol Clinical And Experimental Research 2018, 42: 2337-2348. PMID: 30252935, PMCID: PMC6317871, DOI: 10.1111/acer.13890.Peer-Reviewed Original ResearchConceptsAlcohol withdrawalEpigenomic data setsGenome-wide association studiesWide significant findingsLife-threatening seizuresAlcohol withdrawal symptomsTop association signalsTissue-specific activityNeural lineage cellsGenetic risk factorsHarmful alcohol useAssociation signalsRegulatory elementsBioinformatics analysisStress hormone levelsAlcohol cessationChromosome 4Neurotrophic factorWithdrawal symptomsRisk factorsEthanol exposureHormone levelsAssociation studiesNervous systemAdditional genotypingAlcohol withdrawal hallucinations in the general population, an epidemiological study
Stephane M, Arnaout B, Yoon G. Alcohol withdrawal hallucinations in the general population, an epidemiological study. Psychiatry Research 2018, 262: 129-134. PMID: 29433107, DOI: 10.1016/j.psychres.2018.02.021.Peer-Reviewed Original ResearchConceptsOdds ratioBrain developmentHigher odds ratioLogistic regression analysisMost psychiatric illnessesNational Epidemiologic SurveyAlcohol withdrawalClinical patternWithdrawal seizuresPsychiatric comorbidityMechanisms of hallucinationsPsychiatric illnessUnmarried subjectsEpidemiological studiesGeneral populationEpidemiologic SurveyRelated conditionsAnxiety disordersLow levelsSevere exposureHallucinationsSocial isolationRegression analysisAfrican AmericansSuch history
2017
Alcohol Withdrawal and Lithium Toxicity: A Novel Psychiatric Mannequin-Based Simulation Case for Medical Students
Bhalla IP, Wilkins KM, Moadel T, Wong AH, Trevisan LA, Fuehrlein B. Alcohol Withdrawal and Lithium Toxicity: A Novel Psychiatric Mannequin-Based Simulation Case for Medical Students. MedEdPORTAL 2017, 13: 10649. PMID: 30800850, PMCID: PMC6338141, DOI: 10.15766/mep_2374-8265.10649.Peer-Reviewed Original ResearchConceptsAlcohol withdrawalLithium toxicityHistory of bipolar disorderPsychiatric educationTreating alcohol withdrawalTreatment of patientsMannequin-based simulationFourth-year medical studentsPostsession ratingsBipolar disorderMedical studentsMedical comorbiditiesSubstance usePatientsEmergency roomCo-ingestionStandardized patient actorsMedical student educationMale truck driversNovel caseWithdrawalMedical complexityPatient actorsSimulation mannequinClinical clerkships
2016
Unhealthy Alcohol Use
Holt S, Tetrault J. Unhealthy Alcohol Use. Clinics In Liver Disease 2016, 20: 429-444. PMID: 27373607, DOI: 10.1016/j.cld.2016.02.003.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useAlcohol useSymptom-triggered approachAlcohol use disorderAlcohol withdrawalAppropriate treatmentRoutine screeningPatient motivationUse disordersBrief interventionHazardous drinkingBehavioral therapyHeavy drinkingPatientsRobust dataBehavioral changesDrinkingTwelve-step programsMedicationsTherapyBenzodiazepinesAbstinenceComparison of enteral ethanol and benzodiazepines for alcohol withdrawal in neurocritical care patients
Gipson G, Tran K, Hoang C, Treggiari M. Comparison of enteral ethanol and benzodiazepines for alcohol withdrawal in neurocritical care patients. Journal Of Clinical Neuroscience 2016, 31: 88-91. PMID: 27262870, DOI: 10.1016/j.jocn.2016.02.028.Peer-Reviewed Original ResearchConceptsEnteral ethanolCIWA scoreAlcohol withdrawalEthanol groupIntensive care unit lengthClinical Institute Withdrawal AssessmentAlcohol withdrawal managementRetrospective chart reviewNeurocritical care patientsGlasgow Coma ScaleLength of stayUse of benzodiazepinesLevel of comaAlcohol scale scoresPrimary endpointSecondary endpointsChart reviewClinical characteristicsFirst medicationCare patientsComa ScaleOral intakeEthanol withdrawalWithdrawal AssessmentNeurocritical careNicotine and Nicotine Abstinence Do Not Interfere with GABAA Receptor Neuroadaptations During Alcohol Abstinence
Hillmer AT, Kloczynski T, Sandiego CM, Pittman B, Anderson JM, Labaree D, Gao H, Huang Y, Deluliis G, O'Malley SS, Carson RE, Cosgrove KP. Nicotine and Nicotine Abstinence Do Not Interfere with GABAA Receptor Neuroadaptations During Alcohol Abstinence. Alcohol Clinical And Experimental Research 2016, 40: 698-705. PMID: 26971694, PMCID: PMC4983773, DOI: 10.1111/acer.12997.Peer-Reviewed Original ResearchConceptsGABAA receptor availabilityPositron emission tomographyAlcohol abstinenceAlcohol withdrawalNicotine abstinenceReceptor availabilityTobacco smokingNonhuman primatesContinued nicotine useNicotine replacement therapyWeeks of abstinenceSelf-administer alcoholAdolescent male rhesus macaquesDays of abstinenceSignificant group effectMale rhesus macaquesNicotine cessationNicotine exposureReplacement therapyNicotine useAlcohol dependenceEmission tomographyDrug abstinenceSmokingNicotine
2015
How Imaging Glutamate, γ‐Aminobutyric Acid, and Dopamine Can Inform the Clinical Treatment of Alcohol Dependence and Withdrawal
Hillmer AT, Mason GF, Fucito LM, O'Malley SS, Cosgrove KP. How Imaging Glutamate, γ‐Aminobutyric Acid, and Dopamine Can Inform the Clinical Treatment of Alcohol Dependence and Withdrawal. Alcohol Clinical And Experimental Research 2015, 39: 2268-2282. PMID: 26510169, PMCID: PMC4712074, DOI: 10.1111/acer.12893.Peer-Reviewed Original ResearchConceptsAlcohol dependenceΓ-aminobutyric acidClinical treatmentMajor public health issuePublic health issuePositron emission tomographyRelapse prevention strategiesSingle photon emissionSpecific imaging modalityAlcohol withdrawalTobacco smokingGABA systemNeurotransmitter systemsNeurochemical basisPrevention strategiesDopaminergic functioningEmission tomographyHealth issuesImaging modalitiesWithdrawalSex differencesImaging literatureDopamineTomographyGlutamate
2014
Tobacco smoking interferes with GABAA receptor neuroadaptations during prolonged alcohol withdrawal
Cosgrove KP, McKay R, Esterlis I, Kloczynski T, Perkins E, Bois F, Pittman B, Lancaster J, Glahn DC, O’Malley S, Carson RE, Krystal JH. Tobacco smoking interferes with GABAA receptor neuroadaptations during prolonged alcohol withdrawal. Proceedings Of The National Academy Of Sciences Of The United States Of America 2014, 111: 18031-18036. PMID: 25453062, PMCID: PMC4273348, DOI: 10.1073/pnas.1413947111.Peer-Reviewed Original ResearchConceptsGABAA receptor levelsAlcohol withdrawalTobacco smokingReceptor levelsGABAA receptorsAlcohol-dependent smokersGABAA receptor availabilityMo of abstinenceProlonged alcohol withdrawalGABAA receptor systemCombination of alcoholNicotine blocksComorbid alcoholSustained elevationAlcohol abstinenceNicotine dependenceRobust elevationReceptor availabilityNicotine consumptionSmokingReceptor systemFirst weekNonhuman primatesControl levelsWithdrawal
2011
Neuroimaging insights into the role of cortical GABA systems and the influence of nicotine on the recovery from alcohol dependence
Cosgrove KP, Esterlis I, Mason GF, Bois F, O’Malley S, Krystal JH. Neuroimaging insights into the role of cortical GABA systems and the influence of nicotine on the recovery from alcohol dependence. Neuropharmacology 2011, 60: 1318-1325. PMID: 21276806, PMCID: PMC3078950, DOI: 10.1016/j.neuropharm.2011.01.020.Peer-Reviewed Original ResearchConceptsAlcohol withdrawalTobacco smokingGABA levelsNeuronal functionNeuronal nicotinic acetylcholine receptorsAlcohol-dependent smokersCortical GABA systemGABA neuronal functionProlonged alcohol withdrawalInfluence of nicotineNicotinic acetylcholine receptorsAlcohol-dependent individualsEffects of alcoholPreclinical evidenceRole of alcoholGABA systemPreclinical modelsTobacco smokeErminio CostaBenzodiazepine receptorsAcetylcholine receptorsAlcohol dependenceSmokingPrimary actionClinical experiments
2009
Dopamine and Serotonin Transporter Availability During Acute Alcohol Withdrawal: Effects of Comorbid Tobacco Smoking
Cosgrove KP, Krantzler E, Frohlich EB, Stiklus S, Pittman B, Tamagnan GD, Baldwin RM, Bois F, Seibyl JP, Krystal JH, O'Malley SS, Staley JK. Dopamine and Serotonin Transporter Availability During Acute Alcohol Withdrawal: Effects of Comorbid Tobacco Smoking. Neuropsychopharmacology 2009, 34: 2218-2226. PMID: 19440191, PMCID: PMC4457331, DOI: 10.1038/npp.2009.49.Peer-Reviewed Original ResearchMeSH KeywordsAdultAlcohol DrinkingBrainBrain MappingCase-Control StudiesCocaineDopamine Plasma Membrane Transport ProteinsFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedProtein BindingRadiopharmaceuticalsSerotonin Plasma Membrane Transport ProteinsSmokingStatistics as TopicSubstance Withdrawal SyndromeTomography, Emission-Computed, Single-PhotonYoung AdultConceptsDA transporter availabilityTobacco smokingSerotonin transporter availabilityTransporter availabilityAlcohol drinkersAcute withdrawalAlcohol drinkingLast drinkCIT single photon emissionAcute alcohol withdrawalHeavy alcohol drinkingSingle photon emissionEffects of alcoholControl smokersAlcohol withdrawalSynaptic markersNeuroadaptive changesNonsmokersSmokersSmokingTotal groupBrainstemSignificant positive correlationFirst weekPrevious month
2008
Alcohol Detoxification and Relapse Prevention Using Valproic Acid Versus Gabapentin in Alcohol-dependent Patients
Trevisan L, Ralevski E, Keegan K, Oville A, Vuppalapati D, Gonzalez G, Limoncelli D, Petrakis I. Alcohol Detoxification and Relapse Prevention Using Valproic Acid Versus Gabapentin in Alcohol-dependent Patients. Addictive Disorders & Their Treatment 2008, 7: 119-128. DOI: 10.1097/adt.0b013e31812e6a3c.Peer-Reviewed Original ResearchAlcohol withdrawalDays of treatmentSleep disturbancesAlcohol detoxificationModerate withdrawalValproic acidAcute alcohol withdrawalPlacebo-controlled trialMild withdrawal symptomsDoses of benzodiazepinesPrevention of relapseAlcohol-dependent patientsSymptoms of depressionPhysiologic withdrawalPostwithdrawal periodSupportive treatmentAcute symptomsBenzodiazepine medicationWithdrawal symptomsAcute withdrawalPsychiatric symptomsMale veteransClinical importancePsychiatric distressRelapse prevention
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