Am J Psychiatry 1979; 136:821-823
Copyright © 1979 by American Psychiatric Association
Massive benzodiazepine requirements during acute alcohol withdrawal
E Woo and DJ Greenblatt
Severe alcohol withdrawal developed in an abstinent chronic alcoholic man.
Massive doses of benzodiazepines (2,335 mg of diazepam intravenously,
21,225 mg of oxazepam orally) achieved only marginal control of delirium
and agitation. Analysis of multiple blood samples drawn during and after
the withdrawal episode indicated, as expected, very high concentrations of
diazepam and metabolites and of oxazepam. There was no evidence of an
abnormal pharmacokinetic profile. Benzodiazepine resistance in withdrawing
alcoholics probably reflects a receptor-site phenomenon rather than an
abnormal drug disposition.
