What is the relapse rate in the first year after alcohol detoxification

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Minor signs occur early and subside within 2 days. They include anxiety, tremulousness, insomnia, GI upset, palpitations, diaphoresis, and headache.

Tonic-clonic movements occurring from 2-48 hours after the last drink. This may progress to delirium tremens (DT).

Visual, tactile, or auditory hallucinations from 12-48 hours after the last drink. Vital signs remain normal.

An alcohol withdrawal syndrome with hallucinations, altered mental status, and seizures accompanied by vital sign abnormalities (tachycardia, hypertension, fever). Vital sign abnormalities may be the first clue to diagnosis. DT may lead to death.

48 hours after the last drink, though may be longer

Benzodiazepines for suppression of withdrawal symptoms

Vitamins (particularly thiamine) to treat underlying vitamin deficiencies seen in long-term alcoholism Antihypertensives to suppress underlying hypertension that can be made worse by the physiologic withdrawal process

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