W. LEIGH THOMPSON, M.D.; ALLEN D. JOHNSON, M.D.; WILLIS L. MADDREY, M.D., F.A.C.P.
Thirty-four patients with severe delirium tremens were allocated randomly to treatment with paraldehyde (10 ml rectally every 30 minutes) or diazepam (10 mg then 5 mg intravenously every 5 minutes) until they were calm but awake. Diazepam-treated patients became calm in one half the time needed to calm patients with paraldehyde. Half of the patients had delirium tremens in association with pneumonia, pancreatitis, or alcoholic hepatitis; these patients required twice as much paraldehyde or diazepam for initial calming as patients with delirium tremens alone. Maintenance of a calm state was accomplished easily with either diazepam, intramuscularly, or paraldehyde, rectally. Adverse reactions occurred in nine patients, all of whom had been treated with paraldehyde; these patients had greater degrees of fever, tachypnea, and tachycardia and required three times longer for initial calming than patients without adverse reactions. Diazepam given under this regimen is a safe and effective sedative for management of combative patients with severe delirium tremens.
W. LEIGH THOMPSON, ALLEN D. JOHNSON, WILLIS L. MADDREY. Diazepam and Paraldehyde for Treatment of Severe Delirium Tremens: A Controlled Trial. Ann Intern Med. 1975;82:175–180. doi: 10.7326/0003-4819-82-2-175
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Published: Ann Intern Med. 1975;82(2):175-180.
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