A Comparative Study of the Efficacy of Modified Benzodiazepine Therapy Versus Conventional Therapy in Alcohol-Dependent Patients at Chaiyaphum Hospital's Psychiatric Ward

Abstract

            Alcohol use disorder can lead to serious health complications, including liver disease and heart conditions. Additionally, alcohol withdrawal can be fatal if not managed appropriately. This study, using a quasi-experimental design, aims to compare the severity of alcohol withdrawal symptoms among patients treated with either a conventional or a symptom-triggered benzodiazepine regimen. The study was conducted among patients admitted to the psychiatric ward of Chaiyaphum Hospital between July 2023 and June 2024. A total of 280 patients were included: 140 in the traditional group (fixed dose, loading dose, or intravenous) and 70 in the symptom-triggered group. Alcohol Withdrawal Scale (AWS) scores were assessed daily.

            Results showed that both groups experienced moderate withdrawal symptoms (AWS = 0-3), with a mean age of 44.03 years and generally stable vital signs. The experimental group (symptom-triggered) was discharged after an average of 6 days, while the control group required up to 10 days. Although there was no significant overall difference in AWS scores between the two groups (p-value = 0.587), there were significant differences over time (p-value = 0.002). The experimental group initially had higher AWS scores on the first day (Mean diff. (AWS) = 0.94; 95% CI: 0.42, 1.46) but these decreased rapidly, allowing for earlier discharge. The control group also showed a decrease in AWS scores but at a slower rate. When analyzing individual AWS items, the symptom-triggered regimen was more effective in reducing anxiety, while both regimens were comparable in reducing body temperature.

            Our findings support the implementation of symptom-triggered medication as the initial treatment approach for individuals experiencing mild alcohol withdrawal. Additionally, we recommend further training for healthcare providers in using the AWS assessment tool. Future studies with larger sample sizes and economic evaluations are needed to strengthen these findings.