Management of Alcohol Withdrawal Syndrome
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AWS may be managed with outpatient therapy if the patient has mild to moderate symptoms. (Strength of Recommendation [SOR]: B, based on one randomized, prospective trial). The Clinical Institute Withdrawal Assessment Scale for Alcohol, Revised (CIWA-Ar) may be used to assess symptom severity. (SOR: C, based on consistent reliability and validity from case series studies). The decision to prescribe medication is based on the severity of symptoms. High-quality randomized controlled trials and meta-analyses suggest that long-acting benzodiazepines are generally preferred for managing AWS in the inpatient setting. (SOR: A). However, there is also evidence that benzodiazepines are safe in the outpatient setting. (SOR: B, based on one randomized prospective trial).
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