Internal and Emergency Medicine

, Volume 14, Issue 1, pp 143–160 | Cite as

Diagnosis and treatment of acute alcohol intoxication and alcohol withdrawal syndrome: position paper of the Italian Society on Alcohol

  • Fabio CaputoEmail author
  • Roberta Agabio
  • Teo Vignoli
  • Valentino Patussi
  • Tiziana Fanucchi
  • Paolo Cimarosti
  • Cristina Meneguzzi
  • Giovanni Greco
  • Raffaella Rossin
  • Michele Parisi
  • Davide Mioni
  • Sarino Arico’
  • Vincenzo Ostilio Palmieri
  • Valeria Zavan
  • Pierluigi Allosio
  • Patrizia Balbinot
  • Maria Francesca Amendola
  • Livia Macciò
  • Doda Renzetti
  • Emanuele Scafato
  • Gianni Testino


The chronic use of alcohol can lead to the onset of an alcohol use disorder (AUD). About 50% of subjects with an AUD may develop alcohol withdrawal syndrome (AWS) when they reduce or discontinue their alcohol consumption and, in 3–5% of them, convulsions and delirium tremens (DTs), representing life-threatening complications, may occur. Unfortunately, few physicians are adequately trained in identifying and treating AWS. The Italian Society on Alcohol has, therefore, implemented a task force of specialists to draw up recommendations for the treatment of AWS with the following main results: (1) while mild AWS may not require treatment, moderate and severe AWS need to be pharmacologically treated; (2) out-patient treatment is appropriate in patients with mild or moderate AWS, while patients with severe AWS need to be treated as in-patients; (3) benzodiazepines, BDZs are the “gold standard” for the treatment of AWS and DTs; (4) alpha-2-agonists, beta-blockers, and neuroleptics may be used in association when BDZs do not completely resolve specific persisting symptoms of AWS; (5) in the case of a refractory form of DTs, the use of anaesthetic drugs (propofol and phenobarbital) in an intensive care unit is appropriate; (6) alternatively to BDZs, sodium oxybate, clomethiazole, and tiapride approved in some European Countries for the treatment of AWS may be employed for the treatment of moderate AWS; (7) anti-convulsants are not sufficient to suppress AWS, and they may be used only in association with BDZs for the treatment of refractory forms of convulsions in the course of AWS.


Acute alcohol intoxication Alcohol withdrawal syndrome Pharmacological treatment 


Compliance with ethical standards

Conflict of interest

The author(s) declare that they have no conflict of interest.

Statement of human and animal rights

The Italian Society on Alcohol has followed the Ethical Statements required for a review paper.

Informed consent

For this type of study formal consent is not required.


  1. 1.
    World Health Organization (WHO) (2014) Global status report on alcohol and health. World Health Organization, GenevaGoogle Scholar
  2. 2.
    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5, 5th edn. The American Psychiatric Association, Washington, DCCrossRefGoogle Scholar
  3. 3.
    Grant BF, Goldstein RB, Saha TD, Chou SP, Jung J, Zhang H, Pickering RP, Ruan WJ, Smith SM, Huang B, Hasin DS (2015) Epidemiology of DSM-5 alcohol use disorder: results from the national epidemiologic survey on alcohol and related conditions III. JAMA Psychiatry 72:757–766CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    de Wit M, Jones DG, Sessler CN, Zilberberg MD, Weaver MF (2010) Alcohol-use disorders in the critically ill patient. Chest 138:994–1003CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Rehm J, Mathers C, Popova S et al (2009) Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet 373:2223–2233CrossRefPubMedGoogle Scholar
  6. 6.
    Schuckit MA (2014) Recognition and management of withdrawal delirium (delirium tremens). N Engl J Med 371:2109–2113CrossRefPubMedGoogle Scholar
  7. 7.
    Istituto Superiore di Sanità (2002) National programme of guidelines. Istituto Superiore di Sanità, RomeGoogle Scholar
  8. 8.
    Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P et al (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336:924–926CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Guyatt GH, Oxman AD, Montori V, Vist G, Kunz R, Brozek J et al (2011) GRADE guidelines: 5. Rating the quality of evidence—publication bias. J Clin Epidemiol 64:1277–1282CrossRefPubMedGoogle Scholar
  10. 10.
    Schünemann HJ, Jaeschke R, Cook D, Bria W, El-Solh A, Ernst A et al (2006) An official ATS statement: grading the quality of evidence and strength of recommendations in ATS guidelines and recommendations. Am J Respir Crit Care Med 174:605–614CrossRefPubMedGoogle Scholar
  11. 11.
    Reus VI, Fochtmann LJ, Bukstein O et al (2018) The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. Am J Psych 175:86–90CrossRefGoogle Scholar
  12. 12.
    Pilling S, Yesufu-Udechuku A, Taylor C, Drummond C, Guideline Development Group (2011) Diagnosis, assessment, and management of harmful drinking and alcohol dependence: summary of NICE guidance. BMJ 342:d700CrossRefPubMedGoogle Scholar
  13. 13.
    Rolland B, Paille F, Gillet C, Rigaud A, Moirand R, Dano C, Dematteis M, Mann K, Aubin HJ (2016) Pharmacotherapy for alcohol dependence: the 2015 recommendations of the French alcohol society, issued in partnership with the european federation of addiction societies. CNS Neurosci Ther 22:25–37CrossRefPubMedGoogle Scholar
  14. 14.
    Soyka M, Kranzler HR, Hesselbrock V, Kasper S, Mutschler J, Möller HJ, WFSBP Task Force on Treatment Guidelines for Substance Use Disorders (2017) Guidelines for biological treatment of substance use and related disorders, part 1: alcoholism, first revision. World J Biol Psychiatry 18:86–119CrossRefPubMedGoogle Scholar
  15. 15.
    Schuckit MA (2006) Drug and alcohol abuse. A clinical guide to diagnosis and treatment, 6th edn. Springer, New YorkGoogle Scholar
  16. 16.
    Vonghia L, Leggio L, Ferrulli A et al (2008) Alcohol acute intoxication. Eur J Int Med 19:561–567CrossRefGoogle Scholar
  17. 17.
    Tabakoff B, Hoffman PL (2013) The neurobiology of alcohol consumption and alcoholism: an integrative history. Pharmacol Biochem Bheav 113:20–37CrossRefGoogle Scholar
  18. 18.
    Shpilenya LS, Muzychenko AP, Gasbarrini G, Addolorato G (2002) Metadoxine in acute alcohol intoxication. A double-blind, randomized, placebo-controlled study. Alcohol Clin Exp Res 26:340–346CrossRefPubMedGoogle Scholar
  19. 19.
    Pianca TG, Sordib AO, Hartmannb TC, von Diemen L (2017) Identification and initial management of intoxication by alcohol and other drugs in the pediatric emergency room. J Pediatr 93:46–52CrossRefGoogle Scholar
  20. 20.
    Lamminpää A (1994) Acute alcohol intoxication among children and adolescent. Eur J Pediatr 153:868–872CrossRefPubMedGoogle Scholar
  21. 21.
    Grüne B, Piontek D, Pogarell O, Grübl A, Groß C, Reis O, Zimmermann US, Kraus L (2017) Acute alcohol intoxication among adolescents-the role of the context of drinking. Eur J Pediatr 176:31–39CrossRefPubMedGoogle Scholar
  22. 22.
    Ministry of Health (2017) Annual Report of the Ministry of Health to the Parliament about the interventions on alcohol related problemsGoogle Scholar
  23. 23.
    Walton MA, Chermack ST, Shope JT, Bingham CR, Zimmerman MA, Blow FC, Cunningham RM (2010) Effects of a brief intervention for reducing violence and alcohol misuse among adolescents: a randomized controlled trial. JAMA 304:527–535CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Arnaud N, Diestelkamp S, Wartberg L, Sack PM, Daubmann A, Thomasius R (2017) Short to midterm effectiveness of brief motivational intervention to reduce alcohol use and related problems for alcohol intoxicated children and adolescents in pediatric emergency department: a randomized controlled trial. Acad Emerg Med 24:186–200CrossRefPubMedGoogle Scholar
  25. 25.
    Wiese JG, Shlipak MG, Browner WS (2000) The alcohol hangover. Ann Intern Med 132:897–902CrossRefPubMedGoogle Scholar
  26. 26.
    Penning R, McKinney A, Verster JC (2012) Alcohol Hangover symptoms and their contribution to the overall hangover severity. Alcohol Alcohol 47:248–252CrossRefPubMedGoogle Scholar
  27. 27.
    Jayawardena R, Thejani T, Ranasinghe P, Fernando D, Verster JC (2017) Intervention for treatment of alcohol hangover: systematic review. Hum Psychopharm. CrossRefGoogle Scholar
  28. 28.
    Koob GF, Le Moal M (2006) Alcohol. In: Koob GF, Le Moal M (eds) Neurobiology of addiction. Oxford Academic Press, Oxford, pp 173–241CrossRefGoogle Scholar
  29. 29.
    Mayo-Smith MF (1997) Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. American Society of Addiction Medicine Working Group on Pharmacological Management of Alcohol Withdrawal. JAMA 278:144–151CrossRefPubMedGoogle Scholar
  30. 30.
    Amato L, Minozzi S, Davoli M (2011) Efficacy and safety of pharmacological interventions for the treatment of the Alcohol Withdrawal Syndrome. Cochrane Database Syst Rev 6:CD008537Google Scholar
  31. 31.
    Mirijello A, D’Angelo C, Ferrulli A, Vassallo G, Antonelli M, Caputo F, Leggio L, Gasbarrini A, Addolorato G (2015) Identification and management of alcohol withdrawal syndrome. Drugs 75:353–365CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Jesse S, Bråthen G, Ferrara M, Keindl M, Ben-Menachem E, Tanasescu R, Brodtkorb E, Hillbom M, Leone MA, Ludolph AC (2017) Alcohol withdrawal syndrome: mechanisms, manifestations, and management. Acta Neurol Scand 135:4–16CrossRefPubMedGoogle Scholar
  33. 33.
    Mayo-Smith MF, Beecher LH, Fischer TL et al (2004) Management of alcohol withdrawal delirium. An evidence-based practice guideline. Arch Intern Med 164:1405–1412CrossRefPubMedGoogle Scholar
  34. 34.
    Galvin R, Bråthen G, Ivashynka A, Hillbom M, Tanasescu R, Leone MA (2010) EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol 17:1408–1418CrossRefPubMedGoogle Scholar
  35. 35.
    Attilia F, Perciballi R, Rotondo C, Capriglione I, Iannuzzi S, Attilia ML, Coriale G, Vitali M, Cereatti F, Fiore M, Ceccanti M, interdisciplinary study group CRARL, SITAC, SIPAD, SITD, SIPD (2018) Alcohol withdrawal syndrome: diagnostic and therapeutic methods. Sindrome astinenziale da alcol: processi diagnostici e terapeutici. Riv Psichiatr 53:118–122PubMedGoogle Scholar
  36. 36.
    Long D, Long B, Koyfman A (2017) The emergency medicine management of severe alcohol withdrawal. Am J Emerg Med 35:1005–1011CrossRefPubMedGoogle Scholar
  37. 37.
    Agabio R (2005) Thiamine administration in alcohol-dependent patients. Alcohol Alcohol 40:155–156CrossRefPubMedGoogle Scholar
  38. 38.
    Sarai M, Tejani AM, Chan AH, Kuo IF, Li J (2013) Magnesium for alcohol withdrawal. Cochrane Database Syst Rev 6:CD008358Google Scholar
  39. 39.
    Espay AJ (2014) Neurologic complications of electrolyte disturbances and acid-base balance. Handb Clin Neurol 119: 365–382CrossRefPubMedGoogle Scholar
  40. 40.
    Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM (1989) Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Br J Addict 84:1353–1357CrossRefPubMedGoogle Scholar
  41. 41.
    Perry EC (2014) Inpatient management of acute alcohol withdrawal syndrome. CNS Drugs 28:401–410CrossRefPubMedGoogle Scholar
  42. 42.
    Muncie HL Jr, Yasinian Y, Oge’ L (2013) Outpatient management of alcohol withdrawal syndrome. Am Fam Phys 88:589–595Google Scholar
  43. 43.
    Caputo F, Bernardi M (2010) Medications acting on the GABA system in the treatment of alcoholic patients. Curr Pharm Des 16:2118–2125CrossRefPubMedGoogle Scholar
  44. 44.
    Muzyk AJ, Leung JG, Nelson S et al (2013) The role of diazepam loading for the treatment of alcohol withdrawal syndrome in hospitalized patients. Am J Addict 22:113–118CrossRefPubMedGoogle Scholar
  45. 45.
    Schmidt KJ, Doshi MR, Holzhausen JM, Natavio A, Cadiz M, Winegardner JE (2016) Treatment of severe alcohol withdrawal. Ann Pharmacother 50:389–401CrossRefPubMedGoogle Scholar
  46. 46.
    Mo Y, Thomas MC, Karras GE (2016) Barbiturates for the treatment of alcohol withdrawal syndrome: a systematic review of clinical trials. J Crit Care 32:101–107CrossRefPubMedGoogle Scholar
  47. 47.
    Dixit D, Endicott J, Burry L, Ramos L, Yeung SY, Devabhakthuni S, Chan C, Tobia A, Bulloch MN (2016) Management of acute alcohol withdrawal syndrome in critically ill patients. Pharmacotherapy 36:797–822CrossRefPubMedGoogle Scholar
  48. 48.
    Liang C, Chen J, Gu W, Wang H, Xue Z (2011) Chronic alcoholism increases the induction dose of propofol. Acta Anaesthesiol Scand 55:1113–1137CrossRefPubMedGoogle Scholar
  49. 49.
    Wong A, Benedict NJ, Lohr BR, Pizon AF, Kane-Gill SL (2015) Management of benzodiazepine-resistant alcohol withdrawal across a healthcare system: benzodiazepine dose-escalation with or without propofol. Drug Alchol Depend 154:296–299CrossRefGoogle Scholar
  50. 50.
    Brotherton AL, Hamilton EP, Kloss HG, Hammond DA (2016) Propofol for treatment of refractory alcohol withdrawal syndrome: a review of the literature. Pharmacotheraphy 36:433–442CrossRefGoogle Scholar
  51. 51.
    Rosenson J, Clements C, Simon B et al (2013) Phenobarbital for acute alcohol withdrawal: a prospective randomized double-blind placebo-controlled study. J Emerg Med 44:592–598CrossRefPubMedGoogle Scholar
  52. 52.
    Agence nationale de sècuritè du mèdicament (ANSM) (2017) Recommandation temporaire d'utilisation (RTU) du balcofene dans la prise en charge des patients alcoolo-dependantsGoogle Scholar
  53. 53.
    Agabio R, Carai AM, Gessa GL, Colombo G (2010) Gamma-hydroxybutyric acid (GHB). In: Koob GF, Le Moal M, Thompson RF (eds) Encyclopedia of behavioral neuroscience. Oxford Academic Press, Oxford, pp 76–83CrossRefGoogle Scholar
  54. 54.
    Snead OC, Gibson KM (2005) Gamma-hydroxybutyric acid. N Engl J Med 352:2721–2732CrossRefPubMedGoogle Scholar
  55. 55.
    Leone MA, Vigna-Taglianti F, Avanzi G et al (2010) Gamma-hydroxybutyrate (GHB) for treatment of alcohol withdrawal and prevention of relapses. Cochrane Database Syst Rev 2:CD006266Google Scholar
  56. 56.
    Skala K, Caputo F, Mirijello A et al (2014) Sodium oxybate in the treatment of alcohol dependence: from the alcohol withdrawal syndrome to the alcohol relapse prevention. Exp Opin Pharmacother 15:245–257CrossRefGoogle Scholar
  57. 57.
    Keating GM (2014) Sodium oxybate: a review of its use in alcohol withdrawal syndrome and in maintenance of abstinence in alcohol dependence. Clin Drug Investig 34:63–80CrossRefPubMedGoogle Scholar
  58. 58.
    Gessa GL, Agabio R, Carai M, Lobina C, Pani M, Reali R, Colombo G (2000) Mechanism of the anti-alcohol effect of gamma hydroxybutyric acid (GHB). Alcohol 20:271–276CrossRefPubMedGoogle Scholar
  59. 59.
    Addolorato G, Balducci G, Capristo E et al (1999) Gamma-hydroxybutyric acid (GHB) in the treatment of alcohol withdrawal syndrome: a randomized comparative study versus benzodiazepine. Alcohol Clin Exp Res 23:1596–1604PubMedGoogle Scholar
  60. 60.
    Caputo F, Skala K, Mirijello A, Ferrulli A, Walter H, Lesch O, Addolorato G (2014) Sodium oxybate in the treatment of alcohol withdrawal syndrome: a randomized double-blind comparative study versus oxazepam. The GATE 1 trial. CNS Drugs 28:743–752CrossRefPubMedGoogle Scholar
  61. 61.
    Addolorato G, Leggio L (2010) Safety and efficacy of baclofen in the treatment of alcohol-dependent patients. Curr Pharm Des 16:2113–2117CrossRefPubMedGoogle Scholar
  62. 62.
    Agabio R, Colombo G (2014) GABAB receptor ligands for the treatment of alcohol use disorder: preclinical and clinical evidence. Front Neurosci 8:140CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Agabio R, Leite-Morris K, Addolorato G, Colombo G (2016) Targeting the GABAB receptor for the treatment of alcohol use disorder. In: Colombo G (ed) GABAB receptor. Springer, ChamGoogle Scholar
  64. 64.
    Addolorato G, Leggio L, Abenavoli L, Agabio R, Caputo F, Capristo E, Colombo G, Gessa GL, Gasbarrini G (2006) Baclofen in the treatment of alcohol withdrawal syndrome: a comparative study vs diazepam. Am J Med 119:13–18CrossRefGoogle Scholar
  65. 65.
    Liu J, Wang LN (2017) Baclofen for alcohol withdrawal. Cochrane Datatabase Syst Rev 8:008502Google Scholar
  66. 66.
    Nimmerrichter AA, Walter H, Gutierrez-Lobos KE, Lesch OM (2002) Double blind controlled trial of gamma-hydroxybutyrate and clomethiazole in the treatment of alcohol withdrawal. Alcohol Alcohol 37:67–73CrossRefPubMedGoogle Scholar
  67. 67.
    Hillemacher T, Weinland C, Heberlein A, Wilhelm J, Bayerlein K, Kornhuber J, Frieling H, Bleich S (2008) Treatment with clomethiazole is associated with lower rates of premature discharge during alcohol withdrawal. Pharmacopsychiatry 41:134–137CrossRefPubMedGoogle Scholar
  68. 68.
    Scatton B, Cohen C, Perrault G et al (2001) The preclinical pharmacologic profile of tiapride. Eur Psychiatry 16:29s–34sCrossRefPubMedGoogle Scholar
  69. 69.
    Allain H, Dauzenberg PH, Maurer K, Schuck S, Bonhomme D, Gerard D (2000) Double blind study of tiapride versus haloperidol and placebo agitation and aggressiveness in elderly patients with cognitive impairment. Psychopharmacology 148:361–366CrossRefPubMedGoogle Scholar
  70. 70.
    Peters DH, Faulds D (1994) Tiapride. A review of its pharmacology and therapeutic potential in the management of alcohol dependence syndrome. Drugs 47:1010–1032CrossRefPubMedGoogle Scholar
  71. 71.
    Murphy DJ, Shaw GK, Clarke I (1983) Tiapride and chlormethiazole in alcohol withdrawal: a double-blind trial. Alcohol Alcohol 18:227–237Google Scholar
  72. 72.
    Soyka M, Morhart-Klute V, Horak M (2002) A combination of carbamazepine/tiapride in outpatient alcohol detoxification-results from an open clinical study. Eur Arch Psychiatry Clin Neurosci 252:197–200CrossRefPubMedGoogle Scholar
  73. 73.
    Soyka M, Schmidt P, Franz M, Barth T, De Groot M, Kienast T et al (2006) Treatment of alcohol withdrawal syndrome with a combination of tiapride/carbamazepine: results of a pooled analysis in 540 patients. Eur Arch Psychiatry Clin Neurosci 256:395–401CrossRefPubMedGoogle Scholar
  74. 74.
    Martinotti G, di Nicola M, Frustaci A, Romanelli R, Tedeschi D, Guglielmo R, Guerriero L, Bruschi A, De Filippis R, Pozzi G, Di Giannantonio M, Bria P, Janiri L (2010) Pregabalin, tiapride and lorazepam in alcohol withdrawal syndrome: a multi-centre, randomized, single-blind comparison trial. Addiction 105:288–299CrossRefPubMedGoogle Scholar
  75. 75.
    Minozzi S, Amato L, Vecchi S, Davoli M (2010) Anticonvulsants for alcohol withdrawal. Cochrane Database Syst Rev 3:CD005064Google Scholar
  76. 76.
    European Association for the Study of the Liver (2018) EASL clinical practice guidelines: management of alcohol-related liver disease. J Hepatol 69:154–181CrossRefGoogle Scholar
  77. 77.
    Leggio L, Lee MR (2017) Treatment of alcohol use disorder in patients with alcoholic liver disease. Am J Med 130:124–134CrossRefPubMedGoogle Scholar
  78. 78.
    Addolorato G, Mirijello A, Barrio P, Gual A (2016) Treatment of alcohol use disorders in patients with alcoholic liver disease. J Hepatol 65:618–630CrossRefPubMedGoogle Scholar
  79. 79.
    Caputo F, Bernardi M, Zoli G (2011) Efficacy and safety of γ-hydroxybutyrate in treating alcohol withdrawal syndrome in an alcohol-dependent inpatient with decompensated liver cirrhosis: a case report. J Clin Psychopharmacol 31:140–141CrossRefPubMedGoogle Scholar
  80. 80.
    Marengoni A, Onder G (2015) Guidelines, polypharmacy, and drug–drug interactions in patients with multimorbidity. BMJ. CrossRefPubMedGoogle Scholar
  81. 81.
    Guerzoni S, Pellesi L, Pini LA, Caputo F (2018) Drug-drug interactions in the treatment for alcohol use disorders: a comprehensive review. Pharmacol Res 133:65–76CrossRefPubMedGoogle Scholar
  82. 82.
    Ozdemir M, Aktan Y, Boydag BS, Cingi MI, Musmul A (1998) Interaction between grapefruit juice and diazepam in humans. Eur J Drug Metab Pharmacokinet 23:55–59CrossRefPubMedGoogle Scholar
  83. 83.
    Tanaka E, Misawa S (1998) Pharmacokinetic interactions between acute alcohol ingestion and single doses of benzodiazepines, and tricyclic and tetracyclic antidepressants—an update. J Clin Pharm Ther 23:331–336CrossRefPubMedGoogle Scholar
  84. 84.
    Caputo F, Francini S, Stoppo M, Lorenzini F, Vignoli T, Del Re A, Comaschi C, Leggio L, Addolorato G, Zoli G, Bernardi M (2009) Incidence of craving for and abuse of gamma-hydroxybutyric acid (GHB) in different populations of treated alcoholics: an open comparative study. J Psychopharmacol 23:883–890CrossRefPubMedGoogle Scholar
  85. 85.
    Thai D, Dyer JE, Benowitz NL, Haller CA (2006) GHB and ethanol effects and interactions in humans. J Clin Psychopharmacol 26:524–529CrossRefPubMedPubMedCentralGoogle Scholar
  86. 86.
    Pross N, Patat A, Vivet P, Bidaut M, Fauchoux N (2015) Pharmacodynamic interactionsof a solid formulation of sodium oxybate and ethanol in healthy volunteers. Br J Clin Pharmacol 80:480–492CrossRefPubMedPubMedCentralGoogle Scholar
  87. 87.
    Bonnet U, Lensing M, Specka M, Scherbaum N (2011) Comparison of two oral symptom-triggered pharmacological inpatient treatments of acute alcohol withdrawal: clomethiazole vs. clonazepam. Alcohol Alcohol 46:68–73CrossRefPubMedGoogle Scholar
  88. 88.
    Lugoboni F, Mirijello A, Faccini M, Casari R, Cossari A, Musi G, Bissoli G, Quaglio G, Addolorato G (2014) Quality of life in a cohort of high-dose benzodiazepine dependent patients. Drug Alchol Depend 142C:105–109CrossRefGoogle Scholar

Copyright information

© Società Italiana di Medicina Interna 2018

Authors and Affiliations

  • Fabio Caputo
    • 1
    • 2
    Email author
  • Roberta Agabio
    • 3
  • Teo Vignoli
    • 4
  • Valentino Patussi
    • 5
  • Tiziana Fanucchi
    • 5
  • Paolo Cimarosti
    • 6
  • Cristina Meneguzzi
    • 6
  • Giovanni Greco
    • 7
  • Raffaella Rossin
    • 8
  • Michele Parisi
    • 9
  • Davide Mioni
    • 10
  • Sarino Arico’
    • 11
  • Vincenzo Ostilio Palmieri
    • 12
  • Valeria Zavan
    • 13
  • Pierluigi Allosio
    • 14
  • Patrizia Balbinot
    • 15
  • Maria Francesca Amendola
    • 16
  • Livia Macciò
    • 17
  • Doda Renzetti
    • 18
  • Emanuele Scafato
    • 19
  • Gianni Testino
    • 15
  1. 1.Unit of Internal Medicine, Department of Internal MedicineSS Annunziata HospitalCentoItaly
  2. 2.“G. Fontana” Centre for the Study and Multidisciplinary Treatment of Alcohol Addiction, Department of Medical and Surgical SciencesUniversity of BolognaBolognaItaly
  3. 3.Section of Neuroscience and Clinical Pharmacology, Department of Biomedical SciencesUniversity of CagliariCagliariItaly
  4. 4.Unit of Addiction TreatmentLugoItaly
  5. 5.Regional Centre on AlcoholCareggi HospitalFlorenceItaly
  6. 6.Alcohol UnitPordenoneItaly
  7. 7.Alcohol UnitRavennaItaly
  8. 8.Alcohol UnitMilanItaly
  9. 9.Alcohol UnitNicosiaItaly
  10. 10.Nursing Home Parco dei TigliTeoloItaly
  11. 11.Gastroenterology UnitMauriziano HospitalTurinItaly
  12. 12.“Murri” Clinic of Internal Medicine, Department of Biomedical Science and Human OncologyUniversity of BariBariItaly
  13. 13.Alcohol UnitAlessandriaItaly
  14. 14.Alcohol UnitTurinItaly
  15. 15.Regional Centre on AlcoholGenoaItaly
  16. 16.Alcohol UnitCosenzaItaly
  17. 17.Alcohol UnitSavonaItaly
  18. 18.Department of Internal MedicineMater Dei HospitalBariItaly
  19. 19.National Observatory on Alcohol, National Institute of HealthRomeItaly

Personalised recommendations