Emergency phase: Intravenous thiamine should be administered as soon as KS is suspected. If the person is experiencing an episode of Wernicke's encephalopathy, it is possible that high doses of thiamine can reduce the swelling and resolve most or all of the symptoms. If thiamine is not administered quickly enough, the damage becomes permanent and results in KS.

Stabilization phase: Many people with KS, especially those for whom alcohol was the precipitating factor, have co-occurring medical or mental health conditions. It is important to address these conditions for the best possible outcome, especially if the other diagnoses could affect nutrition or self-care. Other assessments at this stage can include a deeper psychological assessment, physical therapy, occupational therapy, and functional assessments. It is common to transition the person from IV thiamine to oral thiamine. Intravenous or intramuscular (injection) doses will bypass the damaged digestive system and may be more effective. Research supports the use of benfotiamine (oral supplements) over standard oral thiamine. While there are no standard guidelines for oral thiamine dosage, research studies suggest a dosing range from 200-300mg per day.

Maintenance phase: Once multiple aspects of health have been assessed, a maintenance plan can be developed. This will vary greatly by individual, but the part addressing KS can include daily thiamine supplementation, use of neurologic and/or psychiatric medication for memory and mood regulation, physical and occupational therapy, and adjusting to new routines or living arrangements. Most people with KS will need assistance with their housing, legal, and financial affairs in addition to healthcare. Psychotherapy for addiction is usually not engaged due to memory impairment.