clomethiazole-edisylate and Psychoses--Alcoholic

Topics: Alcohol Withdrawal Delirium; Chlormethiazole; Humans; Middle Aged; Psychoses, Alcoholic; Pulmonary Edema

A clinical analysis of 476 cases of delirium tremens is presented. The sample covers virtually all cases of delirium tremens that occurred in the Helsingborg Health Service District during the period 1975-1980. A retrospective analysis of the incidence of delirium tremens over the observation period shows that there was an increase in the number and severity of cases developing delirium tremens when non-cross-tolerant drugs, such as carbamazepine and neuroleptics, were used as first-line treatment for acute alcohol withdrawal. The results also show that when chlormethiazole (a drug exhibiting a certain degree of cross-tolerance with ethanol) was used either as the first-line treatment for all cases or as the first-line treatment for predetermined "high risk" patients, the incidence of delirium tremens was greatly reduced. The favourable findings when chlormethiazole treatment was initiated at an early stage in the "high risk" patients suggest that chlormethiazole has a protective action against delirium tremens. Moreover, in the occasional case in which delirium tremens occurred during chlormethiazole treatment, the disorder was milder and relatively easy to treat.

Topics: Alcohol Withdrawal Delirium; Alcoholism; Chlormethiazole; Drug Administration Schedule; Drug Therapy, Combination; Drug Tolerance; Humans; Psychoses, Alcoholic; Retrospective Studies; Sweden

The effect of hemineurin on the clinical picture and the course of severe forms of delirium tremens was studied over time in 28 male patients who were simultaneously examined for the enzymic activity of the liver and parameters of the cholinergic system. The activity of alanine (AlAT) and aspartate aminotransferases (AsAT), sorbite dehydrogenase (SorDH), fructose-1-phosphate aldolase, blood acetylcholine (AC) levels, the activity of acetylcholine esterase in the whole blood (ACWB) and acetylcholine esterase of red blood cells (ACRC) determined in the course of treatment showed that hemineurin, in addition to a marked sedative effect, contributed to rapid normalization of liver function and carbohydrate metabolism. The effect of hemineurin helped to restore the synthesis and acetylation of CoA, to stimulate AC metabolism, and to set a relative balance of the mediator systems, ensuring the prevention of dangerous complications (acute cardiovascular insufficiency, cerebral edema) in severe cases of delirium tremens.

Topics: Acetylcholine; Acetylcholinesterase; Adult; Alanine Transaminase; Alcohol Withdrawal Delirium; Aspartate Aminotransferases; Chlormethiazole; Fructose-Bisphosphate Aldolase; Humans; L-Iditol 2-Dehydrogenase; Liver; Male; Middle Aged; Parasympathetic Nervous System; Psychoses, Alcoholic

Seizures and delirium tremens were recorded among 292 randomly selected patients admitted to an in-patient alcoholism program. Despite the almost routine prophylactic use of anticonvulsant and sedative drugs the incidence of seizures and delirium tremens during detoxification in hospital was 3%. However, as most alcohol withdrawal seizures occurred immediately before admission, the overall seizure incidence was higher (10%). Those patients who developed seizures during detoxification admitted previous abuse of benzodiazepines or erratic use of phenytoin. The results suggest that prescribing of anticonvulsants to alcoholics may increase their seizure problems, because they are prone to erratic drug taking, and because of drug-alcohol interactions, increased drug metabolism and abuse of the sedative anticonvulsants.

Topics: Adult; Aged; Alcohol Withdrawal Delirium; Alcoholism; Anticonvulsants; Carbamazepine; Chlormethiazole; Female; Humans; Male; Middle Aged; Oxazepam; Pentobarbital; Phenytoin; Psychoses, Alcoholic; Seizures; Substance Withdrawal Syndrome

Topics: Anticonvulsants; Chlormethiazole; Humans; Hypnotics and Sedatives; Mental Disorders; Psychoses, Alcoholic; Psychotic Disorders; Thiazoles