Propofol for Treatment of Refractory Alcohol Withdrawal Syndrome: A Review of the Literature

Pharmacotherapy
Amy L BrothertonDrayton A Hammond

Abstract

The authors evaluated all available evidence on the use of propofol as an adjuvant for the treatment of resistant alcohol withdrawal syndrome (AWS) in comparison to other therapies. A comprehensive PubMed search (1966-December 2015) was conducted using the search terms propofol, alcohol withdrawal, and drug therapy. Articles were cross-referenced for other citations. Clinical studies, case series, and case reports published in the English language assessing the use of propofol in adult patients for treatment of AWS were reviewed for inclusion. Propofol is a sedative-hypnotic that exerts its actions through agonism of GABAA receptors at a different binding site than benzodiazepines and reduces glutamatergic activity through N-methyl-d-aspartase (NMDA) receptor blockade. Dosages from 5 to 100 μg/kg/minute reduced AWS symptoms with frequent development of hypotension and requirement for mechanical ventilation. Patients on propofol often experienced longer durations of mechanical ventilation and length of stay, which may be attributed to more-resistant cases of AWS. When propofol was compared with dexmedetomidine as adjuncts in AWS, both agents showed similar benzodiazepine- and haloperidol-sparing effects. Dexmedetomidine was asso...Continue Reading

References

Jan 1, 1976·Clinical Toxicology·K BlumH Hamilton
Jun 28, 1992·Annals of the New York Academy of Sciences·P L HoffmanB Tabakoff
Oct 1, 1980·Alcoholism, Clinical and Experimental Research·D H ZilmT Y Ti
Jun 1, 1995·Alcoholism, Clinical and Experimental Research·M F Mayo-Smith, D Bernard
Mar 1, 1995·The American Journal of Psychiatry·G TsaiJ T Coyle
Dec 17, 1997·Annals of Emergency Medicine·T R Coomes, S W Smith
Jan 1, 1999·Alcohol and Alcoholism : International Journal of the Medical Council on Alcoholism·M LejoyeuxJ Adès
Jul 13, 2000·Critical Care Medicine·C McCowan, P Marik
Jul 11, 2001·Mayo Clinic Proceedings·T M JaegerV S Pankratz
May 22, 2002·Archives of Internal Medicine·Jean-Bernard DaeppenBertrand Yersin
May 2, 2003·The New England Journal of Medicine·Thomas R Kosten, Patrick G O'Connor
Jul 25, 2003·The New England Journal of Medicine·Gayatri Devi
Oct 15, 2003·Intensive Care Medicine·Claudia D SpiesEdward M Sellers
Feb 21, 2004·The Journal of Clinical Psychiatry·Junji Takeshita
Dec 8, 2004·Current Pharmaceutical Design·Paul E Marik
Nov 8, 2007·Journal of Neurology, Neurosurgery, and Psychiatry·A McKeonNorman Delanty
Dec 12, 2007·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Jason B HackLewis S Nelson
Aug 28, 2010·Critical Care Medicine·MaryClare Sarff, Jeffrey A Gold
Jan 1, 2010·Industrial Psychiatry Journal·Rajiv MahajanRanju Bala
May 25, 2012·Annals of Intensive Care·Samuel G RaynerUNKNOWN Study Institution
Sep 25, 2012·The Journal of Emergency Medicine·Jonathan RosensonHarrison Alter
Nov 28, 2012·Intensive Care Medicine·Don-Kelena AwissiYoanna Skrobik
Oct 1, 2013·The American Journal of Emergency Medicine·Darrel W HughesBruce D Adams
Oct 2, 2013·Indian Journal of Psychiatry·Vihang N Vahia
Jul 12, 2014·Industrial Psychiatry Journal·Shivanand Kattimani, Balaji Bharadwaj
Nov 11, 2014·Clinical Pharmacology : Advances and Applications·Riley J LizotteVeronica L Lesselyoung
Sep 25, 2015·The Annals of Pharmacotherapy·Dustin D Linn, Kathryn C Loeser

❮ Previous
Next ❯

Citations

Jun 25, 2019·JBI Database of Systematic Reviews and Implementation Reports·Marco FioreVincenzo Pota
Nov 29, 2016·Critical Care Nursing Quarterly·Adam L WissG Morgan Jones
Apr 14, 2020·Expert Opinion on Pharmacotherapy·A GlahnT Hillemacher
Mar 12, 2019·La Revue de médecine interne·G AiragnesF Limosin
May 14, 2020·The American Journal of Emergency Medicine·Alexander R LevineEdgar R Naut
Oct 6, 2021·American Journal of Respiratory and Critical Care Medicine·Tessa L SteelEllen L Burnham
Jan 12, 2022·Journal of Psychopharmacology·Alessio CittadiniVanni Agnoletti

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antipsychotic Drugs

Antipsychotic drugs are a class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia and bipolar disorder. Discover the latest research on antipsychotic drugs here

Bradyarrhythmias

Bradyarrhythmias are slow heart rates. Symptoms may include syncope, dizziness, fatigure, shortness of breath, and chest pains. Find the latest research on bradyarrhythmias here.