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Original papers: Claire McIntosh, Valerie Kippen, Fiona Hutcheson, and Andrew McIntosh Parenteral thiamine use in the prevention and treatment of Wernicke-Korsakoff syndrome Psychiatr Bull 2005; 29: 94-97 [Abstract] [Full text] [PDF]

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Parenteral thiamine

Alasdair J Macdonald   (17 March 2005)

Parenteral thiamine 17 March 2005
Alasdair J Macdonald, consultant psychiatrist North Dorset PCT Send letter to journal: Re: Parenteral thiamine ajmacdon{at}psychsft.freeserve.co.uk Alasdair J Macdonald	I was delighted to see the article by McKintosh 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 seven days, so the guidelines given fall short of an adequate dose. Also, it is hard to detect any useful clinical response within two days; my own experience is that 3-4 weeks are required before improvement in memory function can be detected. Guthrie, A. & Elliott, W.A. (1980) The nature and reversibility of cerebral impairment in alcoholism: treatment implications. J Studies Alcohol, 41, 147-155. Macdonald, A.J. (1994). A paper that changed my practice: Reversible mental impairment in alcoholics. British Medical Journal, 308, 1678.