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Treatment of Delirium Tremens

Frederick Lemere, M.D.
JAMA. 1961;178(10):1052. doi:10.1001/jama.1961.03040490078021.
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To the Editor:—  In The Journal (177:589 [Aug. 26] 1961), an answer was given to a question regarding the treatment of delirium tremens. In this answer it was suggested that promazine hydrochloride (Sparine) might be given intramuscularly or intravenously.I would like to draw attention to the danger of giving promazine intravenously as there have been several cases reported of gangrene of the fingers and hand following such an injection. This is probably due to a spasm of the peripheral circulation because of the irritant properties of promazine. It is also conceivable that in these cases the promazine might have inadvertently been injected into the artery instead of the vein. At any rate, promazine should not be given intravenously.Adrenocorticotrophic hormone was also suggested. After several years of trial with this in a large number of cases at the Shadel Hospital, my associates and I have discontinued its use


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