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The Use of Oral Phenobarbital Loading for the Management of Alcohol Withdrawal Syndrome in an Outpatient Setting: A
Erin Hamilton1, Braden Bouchard
1Department of Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (EH); and Department of Emergency Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (BB).
Abstract:
Alcohol withdrawal syndrome is most frequently treated with benzodiazepines, but due to their short half-life, tapering prescriptions are frequently required for outpatients, which presents challenges to both clinicians and patients. Our local health system has had significant success treating alcohol withdrawal in the emergency department with phenobarbital loading doses. As patients also present in alcohol withdrawal to our outpatient addictions clinic, we have adapted our emergency department intravenous protocol to a staggered, oral loading protocol for the treatment of mild and moderate alcohol withdrawal syndrome in the community setting. In this case report, we successfully treat a 36-year-old man with mild alcohol withdrawal symptoms using this approach and without requiring a tapering sedative prescription.
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