{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:22:33Z","timestamp":1768566153226,"version":"3.49.0"},"reference-count":28,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: Alcohol withdrawal syndrome is a common clinical challenge that may lead to significant complications if not properly managed. Symptom-triggered therapy (STT) represents a promising alternative to fixed-dose regimens (FDRs) providing benzodiazepine prescriptions based on objectively quantified withdrawal symptoms. This study aimed to evaluate the effectiveness and safety of STT using the Hamburg Alcohol Withdrawal Scale (HAES) compared to FDRs in the management of inpatient alcohol detoxification. Methods: In a retrospective case\u2013control study, alcohol detoxification treatment in STT was compared with FDRs. During a twelve-month observation period, a total of 123 patients in the STT group were recruited and compared with 123 controls in the FDR group (matched according to sex, age, and current amount of alcohol consumption) treated in the same hospital before the implementation of STT. The study outcomes included the total benzodiazepine dosage, duration of acute detoxification phase, length of inpatient stay, and occurrence of complications such as epileptic seizures and delirium tremens. Results: STT showed a significantly lower total benzodiazepine dosage (22.50 mg vs. 115.00 mg, p &lt; 0.001), a shorter duration of the detoxification phase (48.00 h vs. 201.75 h, p &lt; 0.001), and a reduced length of inpatient stay (23.00 days vs. 28.00 days, p = 0.003) compared to FDRs. There were no significant differences in the rates of complications between the two settings. Linear mixed model analysis revealed that the differences remained highly significant even after adjusting for various explanatory variables (i.e., age, sex, standard units of alcohol, psychiatric comorbidities, treatment discontinuation, and occurrence of any complication). Conclusions: STT appears to be as effective and safe as traditional fixed-dose regimens of benzodiazepines for the management of inpatient alcohol detoxification. This approach may thereby minimize unnecessary pharmacological exposure, facilitate the earlier integration of patients into psychoeducational and psychosocial interventions, and reduce healthcare costs.<\/jats:p>","DOI":"10.3390\/brainsci15070758","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T11:25:17Z","timestamp":1752751517000},"page":"758","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Symptom-Triggered Alcohol Detoxification Compared to Fixed-Dose Regimen of Benzodiazepines: A Retrospective Case\u2013Control Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Laurent","family":"Becciolini","sequence":"first","affiliation":[{"name":"Center for Addictive Disorders, Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, 8001 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabienne","family":"Wehrli","sequence":"additional","affiliation":[{"name":"Institute of Psychology, Department of Clinical Psychology, University of Zurich, 8006 Zurich, Switzerland"},{"name":"Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, 5210 Windisch, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Kronschnabel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, 5210 Windisch, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Wiesendanger","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, 5210 Windisch, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1759-6990","authenticated-orcid":false,"given":"Norbert","family":"Scherbaum","sequence":"additional","affiliation":[{"name":"Department of Addictive Behavior and Addiction Medicine, and Department of Psychiatry and Psychotherapy, LVR University Hospital Essen, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0633-125X","authenticated-orcid":false,"given":"Patrik","family":"Roser","sequence":"additional","affiliation":[{"name":"Department of Addictive Behavior and Addiction Medicine, and Department of Psychiatry and Psychotherapy, LVR University Hospital Essen, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2025, May 11). 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