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A case of prolonged delirium tremens
Jerome Nicholas1, Rajesh Jacob, Rochelle Kinson
1Department of General Psychiatry, Institute of Mental Health, 10 Buangkok View, Singapore. Jacob_rajesh@imh.com.sg
Singapore Medical Journal
|September 6, 2013
Summary
This case study describes a rare five-week delirium tremens episode in an alcohol-dependent patient. Management involved high-dose benzodiazepines, highlighting atypical treatment needs for prolonged alcohol withdrawal syndrome.
Area of Science:
- Neurology
- Psychiatry
- Pharmacology
Background:
- Alcohol dependence is a chronic relapsing brain disorder.
- Delirium tremens (DT) is a severe form of alcohol withdrawal.
- Benzodiazepines are first-line treatment for DT.
Observation:
- A case of prolonged delirium tremens (DT) lasting five weeks is presented.
- The patient demonstrated severe alcohol dependence.
- High-dose benzodiazepine therapy was administered.
Findings:
- The prolonged duration of DT (five weeks) is atypical.
- High-dose benzodiazepine requirement suggests a rare, severe presentation.
- Successful management was achieved with intensive pharmacotherapy.
Implications:
- This case underscores the potential for prolonged and severe alcohol withdrawal syndromes.
- It highlights the need for individualized, high-dose benzodiazepine regimens in refractory DT.
- Further research into the neurobiology of prolonged DT may inform novel therapeutic strategies.
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