Managing alcohol withdrawal.Sedative-hypnotic agents are more effective than neuroleptic neuroleptic /neu·ro·lep·tic/ (-lep´tik) originally, referring to the effects on cognition and behavior of the first antipsychotic agents: a state of apathy, lack of initiative, and limited range of emotion, and in psychotic patients, agents in reducing mortality in alcohol withdrawal delirium popularly known as delirium tremens.In a metaanalysis of nine prospective controlled trials, Dr. Michael F. Mayo-Smith and his associates found a summary relative risk of mortality with neuroleptics of 6.6, compared with sedative hypnotics. Sedative hypnotics were also superior to neuroleptics in reducing the duration of delirium in three of four trials that compared the two agents (Arch. Intern. Med. 164[13]:1405-412, 2004). Intravenous diazepam achieved quicker sedation of patients, compared with rectal paraldehyde paraldehyde (pârăl`dəhīd'), nervous system depressant similar to alcohol in its effects and used as a sedative. A colorless flammable liquid with a disagreeable odor, paraldehyde produces sleep for up to 12 hr. in one study, and there was no difference in sedation times between intramuscular diazepam and oral barbital bar·bi·tal n. A white crystalline barbiturate used as a sedative and hypnotic, especially in the form of its soluble salt, sodium barbital. barbital, barbitone a long-acting barbiturate, used as a hypnotic and sedative. in another, said Dr. Mayo-Smith of the Veterans Affairs Medical Center, Manchester, N.H. In addition to using parenteral rapid-acting sedative-hypnotic agents that are cross-tolerant with alcohol, the investigators recommended comprehensive supportive care, including history, physical exam, and a thorough diagnostic evaluation. |
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