Diazepam and paraldehyde for treatment of severe delirium tremens. A controlled trial.

Abstract

Thirty-four patients with severe delirium tremens were allocated randomly to treatment with paraldehyde (10 ml rectally very 30 minutes) or diazepam (10 mg then 5 mg intravenously every 5 minutes) until they were calm but awake. Diazepam-treated patients became calm in one half the time needed to calm patients with paraldehyde. Half of the patients had delirium tremens in association with pneumonia, pancreatitis, or alcoholic hepatitis; these patients required twice as much paraldehyde or diazepam for initial calming as patients with delirium tremens alone. Maintenance of a calm state was accomplished easily with either diazepam, intramuscularly, or paraldehyde, rectally. Adverse reactions occurred in nine patients, all of whom had been treated with paraldehyde; these patients had greater degrees of fever, tachypnea, and tachycardia and required three times longer for initial calming than patients without adverse reactions. Diazepam given under this regimen is a safe and effective sedative for management of combative patients with severe delirium tremens.

• Authors: W L Thompson, A D Johnson, W L Maddrey
• Journal: Annals of internal medicine (Ann Intern Med) Vol. 82 Issue 2 Pg. 175-80 (Feb 1975) ISSN: 0003-4819 [Print] United States
• PMID: 1090222 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Diazepam
• Paraldehyde

Topics

• Adult
• Alcohol Withdrawal Delirium (drug therapy, etiology)
• Alcoholism (complications)
• Clinical Trials as Topic
• Diazepam (administration & dosage, therapeutic use)
• Female
• Hepatitis (etiology)
• Humans
• Injections, Intramuscular
• Injections, Intravenous
• Male
• Middle Aged
• Pancreatitis (complications)
• Paraldehyde (administration & dosage, adverse effects, therapeutic use)
• Pneumonia (complications)
• Psychoses, Alcoholic (drug therapy)
• Rectum
• Time Factors