A 46-year-old man presented to the casualty with acute onset of seeing lizards all all around him in the room. He has been violent towards members of his brother who tried to bring him to hospital. On history he has a longstanding history of drinking alcohol and using cannabis for 7 years. He had missed his drinks for the last 3 days. On examination his blood pressure is high and he has global confusion. Which of the following can be used in the immediate treatment of the condition?

Correct Answer: Chlordiazepozide
Description: The clinical presentation suggests severe alcohol (ethanol) withdrawal or Delirium Tremens. The immediate management includes the use of long-acting benzodiazepines. In the given choices both Chlordiazepoxide (Librium) and Diazepam are long acting. However, Chlordiazepoxide (Librium) is longer acting than diazepam. The longer acting benzos prevent the serious complications of seizures. Thiamine and multivitamins are used in the initial phase to prevent Wernicke's encephalopathy.
Category: Psychiatry
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