Thiamine for Wernicke-Korsakoff syndrome in alcohol abuse

Thiamine is effective for prevention of Wernicke-Korsakoff syndrome due to alcohol abuse, however there is insufficient evidence about the dose, frequency, or duration of thiamine treatment for prophylaxis against or treatment of Wernicke-Korsakoff syndrome.

A Cochrane review included only one study with a total of 107 subjects. Wernicke-Korsakoff syndrome is caused by a deficiency of vitamin B1 (thiamine). Thiamine has been established as the treatment of choice for over 50 years. Ambrose randomized participants to one of five doses of intramuscular thiamine and measured outcomes after 2 days of treatment. There was a significant difference in favour of the 200 mg/day compared with the 5 mg/day dose in the number of trials taken to reach criterion on a delayed alternation test (MD –17.90, 95% CI –35.4 to –0.40). No significant differences emerged in comparing the other doses with 5 mg/day. The pattern of results did not present a simple dose-response relationship. The study had methodological shortcomings in design and the presentation of results that limited further analysis.

Comment: The quality of evidence is downgraded by limitations in study quality, by imprecise results (few patients and wide confidence intervals) and by indirectness (questionable clinical reliability of the test used for outcome measurement).

Ədəbiyyat

1. Day E, Bentham P, Callaghan R, Kuruvilla T, George S. Thiamine for Wernicke-Korsakoff Syndrome in people at risk from alcohol abuse. Cochrane Database Syst Rev 2004;(1):CD004033 [Last assessed as up-to-date: 10 May 2013].
2. Ambrose ML, Bowden SC, Whelan G. Thiamin treatment and working memory function of alcohol-dependent people: preliminary findings. Alcohol Clin Exp Res 2001 Jan;25(1):112-6.