More criticism of New England Journal CPC on Alcohol Withdrawal

March 28, 2013, 12:46 am

Three months ago, TPR reviewed a discussion of alcohol withdrawal in the New England Journal of Medicine and was unimpressed. Giving the article only 2 skulls, we noted that “the discussion here is so confused, unfocused, and incomplete that it’s surprising that the combined forces of Mass General and the Journal could not produce a more enlightening review.”

In its March 21, 2013 issue, the Journal published 2 letters further taking issue with the piece. Lauren Shawn and Lewis Nelson from the NYU School of Medicine took issue with the authors’ management of delirium tremens, especially there use of haloperidol which may, as we pointed out in our review, decrease the seizure threshold.

Darius Rastegar and Michael Fingerhood of Johns Hopkins make similar points, and note that adequate doses of a benzodiazepine remains the first-line treatment for DTs, an approach that is simple and most often effective.

In reply, the discussants of the CPC say that  . . . well, I couldn’t quite fathom what they were saying in their response, as they argued mechanistically and without reference to any evidence at all.

You can read the entire exchange here.

Related posts:

CPC: alcohol withdrawal with delirium tremens and a significant missed diagnosis

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