Acute alcohol withdrawal complicated by supraventricular tachycardia: Treatment with intravenous propranolol

A case of severe alcohol withdrawal complicated by seizures, hallucinosis, hypertension, and supraventricular tachycardia is presented. When the patient showed no response to intravenous diazepam (total, 70 mg over 30 minutes) three 0.5-mg increments of propranolol were administered intravenously, resulting in immediate conversion to sinus rhythm and reduction of blood pressure from 210/130 mm Hg to 130/80 mm Hg. The use of intravenous propranolol as an adjunct to standard therapy in the alcohol withdrawal syndrome is discussed.