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Thiamine treatment of Wernicke–Korsakoff syndrome in alcoholism

Published online by Cambridge University Press:  02 January 2018

Alasdair Macdonald
Alasdair Macdonald*
Affiliation:
North Dorset Primary Care Trust, Forston Clinic, Dorchester DT2 9TB
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Information
Psychiatric Bulletin , Volume 29 , Issue 6 , June 2005 , pp. 233
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Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Copyright © 2005. The Royal College of Psychiatrists

I was delighted to read the article by McIntosh et al (Psychiatric Bulletin, March 2005, 29, 94-97) encouraging the use of parenteral thiamine for the early treatment of Wernicke-Korsakoff syndrome in alcoholism. Such treatment greatly improves outcome in some alcoholics (Reference Guthrie and ElliottGuthrie & Elliott, 1980; Reference MacdonaldMacdonald, 1994).

However the British National Formulary recommends one pair of high-potency ampoules twice daily for 7 days, so the guidelines given fall short of an adequate dose. Also, it is hard to detect any useful clinical response within 2 days; my own experience is that 3-4 weeks are required before improvement in memory function can be detected.

References

Guthrie, A. & Elliott, W. A. (1980) The nature and reversibility of cerebral impairment in alcoholism: treatment implications. Journal of Studies on Alcohol, 41, 147–155.Google Scholar
Macdonald, A. J. (1994) A paper that changed my practice: reversible mental impairment in alcoholics. BMJ, 308, 1678 Google Scholar
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