Patient a known case off alcohol dependence after 3 days of last drink develops change in behaviour that he says he could see 5 cm people throwing stones at him, acts as if he is working in his workshop, frightened pacing in and out of the house with worsening more in the night. The possible diagnosis is delirium tremens.Treatment for the above mentioned patient

Detoxification implies removal of the toxic substance from the body, this can be done by using a drug similar to alcohol and thus benzodiazepine is chosen. This is the main drug used in treatment of alcohol withdrawal despite the problem being simple withdrawal, rum fits or delirium tremens IF LIVER FUNCTION IS WITHIN NORMAL LIMITS CHOOSE CHLORDIAZEPOXIDE, AS IT HAS A SIMILAR STRUCTURAL FORMULA LIKE ALCOHOL IF LIVER FUNCTION IS ABNORMAL CHOOSE LORAZEPAM, AS IT DOES NOT WORSEN LIVER DERANGEMENTS FRONT LOADING=====patient is loaded with benzodiazepines SYMPTOM TRIGGER=== benzodiazepines is offered only as and when the withdrawal symptom arises FIXED DOSAGE====== regular fixed dosage of benzodiazepine is given in divided doses and slowly tapered so that the patient is not on any drugs by the end of 2 weeks ref.Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no.625