section name header

Evidence summaries

Thiamine for Wernicke-Korsakoff Syndrome in Alcohol Abuse

Thiamine appears to be 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. Level of evidence: "B"

A Cochrane review [Abstract] 1 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 2 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 imprecise results (few patients and wide confidence intervals).

    References

    • Day E, Bentham PW, Callaghan R et al. Thiamine for prevention and treatment of Wernicke-Korsakoff Syndrome in people who abuse alcohol. Cochrane Database Syst Rev 2013;(7):CD004033. [PubMed]
    • 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. [PubMed]

Primary/Secondary Keywords