Fixed-dose schedule and symptom-triggered regimen for alcohol withdrawal: a before-after study

Objectives: To evaluate the efficacy, safety, benefits and cost of alcohol detoxification after switching from a fixed-dose schedule (FDS) to a symptom-triggered regimen (STR). Methods: This retrospective study was carried out in inpatients receiving alcohol detoxification. The data of alcohol dependent patients receiving STR during March -September 2006 were compared with those of patients treated with FDS between August 2005 and February 2006. Results: The mean age, alcohol use and history of delirium tremens were not significantly different between groups. The mean dosage of benzodiazepines in the STR group (91.3 mg equivalent to diazepam) was lower than that of FDS (465.3 mg equivalent to diazepam), (p<.001). The mean length of hospitalization was shorter in the STR group (10.6 vs. 16.8 days, p=.003). There was no significant difference in major complications. Oversedation was significantly less frequent in the STR group (p <.001). The treatment cost was significantly lower in the STR group (p<.05). Conclusions: Despite the limitations of the study design, STR is as effective as FDS with less frequent complications, shorter length of hospitalization and decreased cost of treatment.