Be Prepared to Treat Alcohol Withdrawal Patients Refractory to Benzodiazepines

You'll hear controversy over the best way to treat alcohol withdrawal refractory to standard benzodiazepine doses.

We know symptom-triggered benzo protocols help prevent seizures and delirium tremens (DTs). But treating a severe alcohol withdrawal patient who isn't responding to escalating benzo doses can be tricky.

About 25% of patients can be refractory...such as needing more than lorazepam 40 mg or diazepam 200 mg in the first 3 hours. Expect many of these patients to need ICU care.