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Psychiatric Bulletin (2005) 29: 233. doi: 10.1192/pb.29.6.233
© 2005 The Royal College of Psychiatrists
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Psychiatric Bulletin (2005) 29: 233
© 2005 The Royal College of Psychiatrists

Correspondence

Thiamine treatment of Wernicke-Korsakoff syndrome in alcoholism

Alasdair Macdonald, Consultant Psychiatrist

North Dorset Primary Care Trust, Forston Clinic, Dorchester DT2 9TB

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 (Guthrie & Elliott, 1980; Macdonald, 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.[Medline]

MACDONALD, A. J. (1994) A paper that changed my practice: reversible mental impairment in alcoholics. BMJ, 308, 1678





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