Treatment of alcohol withdrawal delirium with diazepam and haloperidol

Aim: To study the efficacy and safety of Diazepam in combination with Haloperidol for the treatment of Delirium Tremens.

Material and Methods: 20 consecutive hospitalized patients (16 male, 4 female, mean age 42yo) with Delirium Tremens, according to DSM IV criteria, were studied. The majority (65%) were attended in the Internal Medicine Dept. 6 (30%) patients were immigrants and 4 (20%) had medical record of Delirium Tremens in the past. 10 patients (50%) suffered from severe medical conditions (Hepatic Failure, Pneumonia, Acute Myocardial Infraction).

16 patients (80%) received 30 mg Diazepam IM divided in three daily doses and the rest 4 patients, due to severe hepatic failure, received 20 mg Diazepam IM divided in two daily doses. Haloperidol (10-20 mg daily IM) was added to the treatment if patient symptoms were persistent. All patients received Thiamine 250 mg IM. After complete remission of symptoms Diazepam doses were gradually reduced and Haloperidol was discontinued.

Results: Diazepam alone was sufficient treatment for 2 patients. 18 patients needed to be treated with a combination of Diazepam and Haloperidol. Convulsions occured in one patient. One patient presented with Korsakoff syndrome. The clinical outcome was very good for all of our patients after treatment.

Conclusions: Treatment of Delirium Tremens with Diazepam and Haloperidol is efficient and safe, according to our study and the recent literature.

Key words: Delirium tremens, diazepam, Haloperidol, Thiamine.