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Treatments for other health problems

If you have other mental health problems, these may improve after you stop drinking. If you have depression or anxiety and your symptoms do not improve after 3–4 weeks of being alcohol-free, care staff should offer you specific treatment for these problems. If you have a severe mental health problem or you have thoughts of suicide, you should be referred to a psychiatrist. So that you get the most out of psychological treatment for other mental health problems, you will need to be alcohol-free or have significantly reduced your drinking.

If you are also misusing drugs (such as heroin, cocaine or cannabis), this should be treated alongside your alcohol problem. If you smoke tobacco, you should be encouraged to try to stop smoking.

Wernicke's encephalopathy and Wernicke–Korsakoff syndrome

Wernicke's encephalopathy and Wernicke–Korsakoff syndrome are two related serious conditions caused by lack of a vitamin called thiamine (vitamin B1), which causes harm to the brain and nervous system. People who drink heavily over a long period of time, particularly those who are not eating properly, often have low levels of thiamine. Signs of Wernicke's encephalopathy include uncontrollable and jerky eye movements, problems with walking and coordination, confusion and memory loss. However, some people may not show all of these signs, which can sometimes make it difficult for care staff to recognise the condition.

If Wernicke's encephalopathy is not properly treated, it can develop into a long-term condition called Wernicke–Korsakoff syndrome, with severe memory loss.

If your healthcare professional thinks that you have, or are at high risk of developing, Wernicke's encephalopathy, they should offer you thiamine either as tablets or as an injection. You should also be offered thiamine as an injection and then as tablets to help prevent Wernicke–Korsakoff syndrome if you go through planned withdrawal from alcohol in a specialist alcohol centre or if you are in prison and you do not get enough nutrients from your food, or if you have alcohol-related liver disease.

NICE has produced a separate guideline on treating physical health problems caused by drinking alcohol, including problems caused by a lack of thiamine.

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