Diazepam and paraldehyde for treatment of severe delirium tremens. A controlled trial.

W. L. Thompson, A. D. Johnson, W. L. Maddrey

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88 Scopus citations


Thirty-four patients with severe delirium tremens were allocated randomly to treatment with paraldehyde (10 ml rectally very 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.

Original languageEnglish (US)
Pages (from-to)175-180
Number of pages6
JournalAnnals of internal medicine
Issue number2
StatePublished - Feb 1975

ASJC Scopus subject areas

  • Internal Medicine


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