Alcohol withdrawal syndrome

Alcohol withdrawal syndrome is a set of symptoms that can occur following a reduction in alcohol use after a period of excessive drinking. Symptoms typically include anxiety, restlessness, and irritability, which may progress to severe complications such as seizures, hallucinations, and delirium tremens if not treated.

Ethanol-structural

File:DeliriumTremens.jpg

DeliriumTremens

An alcoholic man with delirium Wellcome L0060780 (level correction)

Pathophysiology

Alcohol withdrawal syndrome results from the sudden discontinuation or decrease of prolonged and excessive alcohol intake, leading to central nervous system hyperactivity. Alcohol inhibits the neurotransmitter gamma-aminobutyric acid (GABA) and increases the excitatory neurotransmitter glutamate. When alcohol is withdrawn, there is a rebound effect resulting in overactivity of the nervous system, which leads to the symptoms of withdrawal.

Symptoms

Alcohol withdrawal symptoms can vary from mild symptoms such as insomnia, tremulousness, and mild anxiety, to severe complications such as withdrawal seizures and delirium tremens. Symptoms may occur from 6 hours to 48 hours after the last drink and may last for up to a week. In severe cases, individuals may experience hallucinations, severe agitation, fever, and autonomic instability.

Treatment

The primary treatment for alcohol withdrawal syndrome is medication to reduce symptoms, and in severe cases, hospitalization may be required. Benzodiazepines are the medication of choice for treating alcohol withdrawal syndrome, while other medications such as anticonvulsants and adrenergic medications may also be used.

Prevention

Prevention of alcohol withdrawal syndrome is primarily achieved by addressing problematic drinking behaviors. This often involves a combination of therapy, counselling, self-help groups like Alcoholics Anonymous (Alcoholics Anonymous), and medical treatment.

Long-Term Complications

Repeated episodes of alcohol withdrawal may lead to a condition known as kindling, where each subsequent withdrawal episode becomes more severe than the previous ones, even if the consumption was less than the previous withdrawal episode. Kindling can lead to complications and may increase the risk of relapse, alcohol-related brain damage, and cognitive deficits.

Society and Culture

Alcohol withdrawal syndrome has a significant societal impact and is a major challenge in healthcare systems worldwide. It is a common cause of hospital admission and involves considerable healthcare costs due to the need for close monitoring and prolonged treatment.

Summary

Alcohol withdrawal syndrome (AWS) is a set of symptoms that can occur following a reduction in alcohol use after a period of excessive use. Symptoms typically include anxiety, shakiness, sweating, vomiting, fast heart rate, and a mild fever. More severe symptoms may include seizures, seeing or hearing things that others do not, and delirium tremens (DTs). Symptoms typically begin around six hours following the last drink, are worst at 24 to 72 hours, and improve by seven days.

See also

• Alcohol dependence
• Delirium tremens
• Substance withdrawal syndrome

Alcohol withdrawal syndrome Resources
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