Alternative, Symptomatic and Other Medications

Benzodiazepines are considered the first line treatment for alcohol withdrawal management. However, benzodiazepines are not recommended, or need to be used cautiously, in circumstances where they: 

• have been used contrary to advice (for example, used in higher doses, used with continued alcohol use); in which case, greater supervision of medication, such as residential withdrawal setting or limit access to benzodiazepines in ambulatory settings, is needed;
• cause paradoxical reactions (such as violence, agitation) or severe alterations in mental status (such as confusion, delirium) in a minority of people; in this case, alternative medication approaches may need to be considered. Such a history, ideally should be verified, and documented.