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Severe alcohol withdrawal has a significant morbidity and mortality rate, especially with a pre-existing co-morbid state. Repeated alcohol withdrawal episodes may sensitize the patient, making future episodes more severe and harder to treat. Benzodiazepines have been found to be safe and effective in the treatment of alcohol withdrawal. However, their abuse liability, their cross-tolerance with alcohol, and the increased risk of relapse to other drugs of abuse limit their use in outpatient settings. The authors discuss some of the neuropharmacological aspects of alcohol withdrawal and drug treatment options with a focus on anticonvulsant drugs. Medications such as sodium valproate, carbamazepine, gabapentin, and topiramate are discussed and their role in the clinical setting addressed. Finally, the authors discuss the potential utility of newer approaches in managing anxiety associated with alcohol withdrawal, such as the use of neurosteroids. [ABSTRACT FROM AUTHOR]