Insufficient evidence of efficacy of thiamine for the treatment of Wernicke-Korsakoff syndrome

Alcohol abuse is an important but not an exclusive cause of Wernicke-Korsakoff syndrome. Although WKS is reasonably well defined and known to cause significant mortality and morbidity, the optimal treatment strategy is not clear. The role of thiamine in treating some of the features of the WKS has been frequently recorded, but recommendations about dosage and duration of treatment are acknowledged to be arbitrary. Two studies were identified that met the inclusion criteria, but only one contained sufficient data for quantitative analysis. This study had methodological shortcomings in design and the presentation of results that limited further analysis. There is therefore insufficient evidence from randomized controlled clinical trials to guide clinicians in the dose, frequency, route or duration of thiamine treatment for prophylaxis against or treatment of WKS due to alcohol abuse.