Psych: Alcohol Withdrawal and Delirium Tremens: Free MSRA Podcast

⚕️FREE MSRA PODCAST –Alcohol Withdrawal🎧 A clear, high-yield breakdown of this potentially life-threateningpsychiatric emergency – perfect forexam prep and real-life clinical scenarios. 🧠Key Learning Points📌Definition• Alcohol withdrawalis a clinical syndrome that occurs after abrupt cessation or reduction of prolongedheavy alcohol use in individuals with physicaldependence.• Can range frommild symptoms to delirium tremens (DTs) –a medical emergency.📌Causes & RiskFactors• Chronic alcohol misuse• Previous withdrawal episodes• Co-existing medical or psychiatric illness• Sudden cessationdue to illness, surgery, or detox attempts💡Mnemonic: “WASTED” –Withdrawal history, Alcohol use, Support lacking, Taper absent, Existingillness, Detox attempt📌Pathophysiology• Alcohol enhances GABA (inhibitory) and inhibits NMDA/glutamate (excitatory)• Chronic use leadsto brain adaptation – less GABA effect,more NMDA activity• Sudden cessation →hyperexcitable CNS = tremors, seizures,hallucinations💡Brakes off,accelerator floored – brain goes into overdrive📌Symptoms• 6–12h: Tremor, sweating, anxiety, insomnia• 12–24h: Hallucinations (auditory/visual)• 24–48h: Seizures (generalised tonic-clonic)• 48–72h: Delirium tremens (confusion, agitation,tachycardia, hallucinations, fever)💡Mnemonic: “THaSeD” –Tremor, Hallucinations, Seizures, Delirium📌DifferentialDiagnosis• Other substancewithdrawal (e.g., benzodiazepines)• Metabolicderangements (e.g., hypoglycaemia)• Neurologicalconditions (e.g., meningitis, epilepsy)• Psychiatricdisorders (e.g., psychosis)📌Diagnosis• Primarily clinical, based on history and exam• Key questions:amount, duration, last drink, past withdrawal• CIWA-Ar scale: Quantifies withdrawal severity• Supportive tests: LFTs, electrolytes,blood alcohol level, rule out otherpathology📌Management• First-line: Benzodiazepines– Long-acting (e.g. chlordiazepoxide, diazepam)– Taper over 5–7 days, tailored to severity• Supportive care: Vitals monitoring,fluid/electrolyte correction• Parenteral thiamine (Pabrinex) before glucoseto prevent Wernicke's• Carbamazepine if history of seizures• Avoid routine antipsychotics and phenytoin• Admit if: priorseizures/DTs, failed home detox, under 18, poor support💡Mnemonic: “Be ThereFor The Patient” – Benzos, Thiamine, Fluids, Tailored plan, Psychiatric input📌Complications• Seizures• Delirium tremens• Wernicke’s encephalopathy• Cardiorespiratory instability• Death if unmanaged📌Prognosis• Good with early treatment and support• Risk ofcomplications rises with delayed recognitionor underlying illness• Long-term success depends on follow-up, socialsupport, and addressing comorbidities 📎More MSRA Resourcesfor Alcohol Withdrawal📝 Revision Notes: https://www.passthemsra.com/topic/alcohol-withdrawal-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/alcohol-withdrawal-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/alcohol-withdrawal-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/alcohol-withdrawal-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/psychiatry-for-the-msra/ Hashtags#MSRA #MSRARevision#MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQ&ANotes#MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision#MSRARevisionWebsite #Psychiatry #AlcoholWithdrawal