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Evaluation of phenobarbital dosing strategies for hospitalized patients with alcohol withdrawal syndrome.

Publication ,  Journal Article
Stallworth, S; Stilley, K; Viriyakitja, W; Powers, S; Parish, A; Erkanli, A; Komisar, J
Published in: Gen Hosp Psychiatry
2023

OBJECTIVE: Alcohol remains the fourth‑leading preventable cause of death in the U.S. The objective of this study was to compare the incidence of phenobarbital (PHB)-resistant withdrawal and determine risk factors for PHB-resistant alcohol withdrawal syndrome (AWS). METHODS: This retrospective cohort study included adults admitted to an academic center with AWS who received PHB as part of an institution-specific treatment protocol. The primary outcome was incidence of AWS resistant to initial protocolized PHB load across two cohorts (standard-dose, 10 mg/kg vs. low-dose, 6 mg/kg). RESULTS: Among 176 included patients, there was no difference in the incidence of PHB-resistant AWS based on initial PHB load [low-dose load, 21 (18.3%) vs. standard-dose load, 12 (19.7%), p = 0.82]. There were also no differences in observed PHB-related ADEs between the groups. Total benzodiazepine dose received (mg) in the 24 h prior to initial PHB load was the only risk factor significantly associated with AWS resistant to initial protocolized PHB load [adjusted OR 1.79 (95% CI 1.24, 2.60)]. PHB-resistant withdrawal occurred in 33 (18.8%) patients with a median cumulative PHB dose of approximately 20 mg/kg during hospitalization. CONCLUSION(S): There were no differences in the incidence of PHB-resistant AWS or PHB-related ADEs based on initial PHB loading dose.

Duke Scholars

Published In

Gen Hosp Psychiatry

DOI

EISSN

1873-7714

Publication Date

2023

Volume

85

Start / End Page

155 / 162

Location

United States

Related Subject Headings

  • Substance Withdrawal Syndrome
  • Retrospective Studies
  • Psychiatry
  • Phenobarbital
  • Humans
  • Benzodiazepines
  • Alcoholism
  • Adult
  • 4203 Health services and systems
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Stallworth, S., Stilley, K., Viriyakitja, W., Powers, S., Parish, A., Erkanli, A., & Komisar, J. (2023). Evaluation of phenobarbital dosing strategies for hospitalized patients with alcohol withdrawal syndrome. Gen Hosp Psychiatry, 85, 155–162. https://doi.org/10.1016/j.genhosppsych.2023.10.014
Stallworth, Sara, Kelsey Stilley, Wassamon Viriyakitja, Shelby Powers, Alice Parish, Alaattin Erkanli, and Jonathan Komisar. “Evaluation of phenobarbital dosing strategies for hospitalized patients with alcohol withdrawal syndrome.Gen Hosp Psychiatry 85 (2023): 155–62. https://doi.org/10.1016/j.genhosppsych.2023.10.014.
Stallworth S, Stilley K, Viriyakitja W, Powers S, Parish A, Erkanli A, et al. Evaluation of phenobarbital dosing strategies for hospitalized patients with alcohol withdrawal syndrome. Gen Hosp Psychiatry. 2023;85:155–62.
Stallworth, Sara, et al. “Evaluation of phenobarbital dosing strategies for hospitalized patients with alcohol withdrawal syndrome.Gen Hosp Psychiatry, vol. 85, 2023, pp. 155–62. Pubmed, doi:10.1016/j.genhosppsych.2023.10.014.
Stallworth S, Stilley K, Viriyakitja W, Powers S, Parish A, Erkanli A, Komisar J. Evaluation of phenobarbital dosing strategies for hospitalized patients with alcohol withdrawal syndrome. Gen Hosp Psychiatry. 2023;85:155–162.
Journal cover image

Published In

Gen Hosp Psychiatry

DOI

EISSN

1873-7714

Publication Date

2023

Volume

85

Start / End Page

155 / 162

Location

United States

Related Subject Headings

  • Substance Withdrawal Syndrome
  • Retrospective Studies
  • Psychiatry
  • Phenobarbital
  • Humans
  • Benzodiazepines
  • Alcoholism
  • Adult
  • 4203 Health services and systems
  • 3202 Clinical sciences