A 45-year-old man with alcohol use disorder and a history of two prior withdrawal seizures is undergoing detoxification. Which is the most appropriate medication to prevent further seizures?
- A Oral phenytoin
- B Oral carbamazepine
- C Intravenous lorazepam ✓
- D Oral disulfiram
Correct answer: C. Intravenous lorazepam
Explanation
Benzodiazepines are the first-line treatment for preventing alcohol withdrawal seizures because they correct the underlying GABAergic deficit. Anticonvulsants like phenytoin or carbamazepine are not effective for this purpose. Disulfiram is an aversive agent for relapse prevention and has no role in seizure prophylaxis. IV lorazepam provides rapid, reliable seizure prevention.
Reference: Harrison's Principles of Internal Medicine, 20th ed.
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