Atenolol for Alcohol Withdrawal

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Abstract
To the Editor: Dr. Kraus et al. are to be commended for their investigation of the use of atenolol in patients with alcohol withdrawal (Oct. 10 issue).1 Their article raises several interesting concerns. How was informed consent obtained in this group of patients? Was oxazepam the sole benzodiazepine used, or were other sedatives employed? Since oxazepam undergoes hepatic conjugation and renal excretion of inactive metabolites, and since beta-blockers may reduce both hepatic and renal blood flow,2 , 3 is it not possible that the lower dose requirement in the treated group was due to a perturbation in oxazepam pharmacokinetics induced by beta-blockade? . . .