HOW ADEQUATE IS TREATMENT WITH ORAL THIAMINE?
A survey of the current practice of psychiatrists and A&E medicine specialists, who are frequently responsible for treating alcohol misusers, showed that there was no consensus as to which vitamins might be beneficial, nor the best method of administering them (Hope et al., 1999). In addition there is disturbing evidence of an increase in the prevalence of KP in the UK (Ramayya and Jauhar, 1997; Smith and Flanigan, 1998). It is entirely reasonable to recommend that well-nourished patients, with no history of dietary neglect, adequate dietary intake and no neuropsychiatric symptoms/signs of WE or peripheral neuropathy be given oral thiamine hydrochloride 100 mg orally three times per day (Morgan and Ritson, 1998). This recommendation assumes that an adequate dietary history or evaluation has been carried out. This group of patients as described are at minimal risk of developing WE, although between 30 and 80% of alcoholic patient populations have low circulating levels of thiamine, depe
