Which benzodiazepine is commonly used in alcohol withdrawal detoxification?

• A. Diazepam
• B. Lorazepam
• C. Chlordiazepoxide
• D. Sertraline

Answer: (A)

In alcohol withdrawal detox, the goal is to prevent withdrawal symptoms from escalating, especially seizures and delirium tremens, by providing a steady, long-acting sedative effect that calms the nervous system. A long-acting benzodiazepine is preferred because its effects persist longer due to active metabolites, giving smooth and continuous coverage as withdrawal evolves. Diazepam is commonly used for this purpose because its long half-life and active metabolite provide durable symptom control, reduce the risk of rebound agitation, and allow a straightforward taper as the patient improves. Its rapid onset also helps quickly suppress acute withdrawal symptoms if they flare.

In practice, this approach helps stabilize patients in both inpatient and outpatient detox settings and can be adjusted with a symptom-guided or fixed-taper regimen. It’s worth noting that in patients with significant liver disease, other benzodiazepines like lorazepam or oxazepam may be favored due to less reliance on hepatic metabolism and lack of active metabolites, but in typical detox situations, diazepam remains a common first-line choice. Sertraline, meanwhile, is not used for acute withdrawal management since it does not address the immediate withdrawal symptoms.