In alcohol withdrawal, drug of choice is-
**Core Concept**
Alcohol withdrawal syndrome is a clinical condition that occurs when an individual suddenly stops or significantly reduces their alcohol consumption after prolonged and heavy drinking. The underlying pharmacological principle involves the disruption of GABA (gamma-aminobutyric acid) and glutamate neurotransmitter balance in the brain.
**Why the Correct Answer is Right**
The drug of choice for managing alcohol withdrawal is benzodiazepines, specifically chlordiazepoxide or diazepam. These medications work by enhancing the effect of GABA, the primary inhibitory neurotransmitter in the brain, thereby reducing the symptoms of withdrawal such as anxiety, tremors, and seizures. They also have a long half-life, which allows for once-daily dosing and helps to prevent withdrawal symptoms from recurring.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as there is no established pharmacological treatment for alcohol withdrawal that involves the use of antipsychotics. Antipsychotics may even exacerbate the condition by blocking dopamine receptors.
**Option B:** This option is incorrect as barbiturates are not the preferred treatment for alcohol withdrawal. They can worsen respiratory depression and have a higher risk of dependence.
**Option C:** This option is incorrect as opioids are not used to treat alcohol withdrawal. Opioid agonists can even precipitate opioid withdrawal symptoms.
**Clinical Pearl / High-Yield Fact**
Benzodiazepines, particularly chlordiazepoxide, can be administered in a specific dosing regimen for alcohol withdrawal, known as the "Symptom Severity Scale." This involves titrating the dose based on the patient's symptoms, starting with 50-100 mg of chlordiazepoxide orally every 2 hours as needed, with a maximum dose of 300 mg per day.
**Correct Answer:** C. Diazepam