J Neurol Neurosurg Psychiatry 79:854-862 doi:10.1136/jnnp.2007.128322
  • Review

The alcohol withdrawal syndrome

  1. A McKeon1,
  2. M A Frye2,
  3. Norman Delanty1
  1. 1
    Department of Neurology and Clinical Neurosciences, Beaumont Hospital, Dublin, and Royal College of Surgeons in Ireland, Dublin, Ireland
  2. 2
    Department of Psychiatry, Mayo Clinic, Rochester, MN, USA
  1. Andrew McKeon, Department of Neurology, Gonda 8 South, Mayo Clinic, 200 1st St Sw, Rochester, MN 55905, USA; mckeon.andrew{at}
  • Received 25 June 2007
  • Revised 12 October 2007
  • Accepted 17 October 2007
  • Published Online First 6 November 2007


The alcohol withdrawal syndrome (AWS) is a common management problem in hospital practice for neurologists, psychiatrists and general physicians alike. Although some patients have mild symptoms and may even be managed in the outpatient setting, others have more severe symptoms or a history of adverse outcomes that requires close inpatient supervision and benzodiazepine therapy. Many patients with AWS have multiple management issues (withdrawal symptoms, delirium tremens, the Wernicke–Korsakoff syndrome, seizures, depression, polysubstance abuse, electrolyte disturbances and liver disease), which requires a coordinated, multidisciplinary approach. Although AWS may be complex, careful evaluation and available treatments should ensure safe detoxification for most patients.


  • Competing interests: None.

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