Alcohol Withdrawal Syndrome

Overview

Alcohol Withdrawal Syndrome is the term given to a combination of symptoms that arise during a sudden cessation of alcohol consumption. The period for which Alcohol Withdrawal Syndrome is diagnosed is usually between three and seven days after intake termination. It typically occurs in excessive drinkers who have regularly consumed eight or more standard strength alcoholic drinks per day. Symptoms can range from moderate to severe and individual responses to alcohol cessation are varied.

The Pathophysiology of Alcohol Withdrawal Syndrome

Alcohol and the Nervous System

The consumption of alcohol slows down the Central Nervous System by activating the Gamma Aminobutyric Acid (GABA) (GABA) inhibitory Neurotransmitter system and altering the responsiveness of Catecholamines (Adrenaline and Norepinephrine) and Glutamic Acid. Frequent excessive alcohol intake and chronic alcohol use gradually make the GABA, Glutamic Acid and Catecholamine inhibitor mechanisms less responsive. In sudden contrast, when alcohol is withdrawn from the body, restraints upon the Central Nervous System are let go. It can take up to four days for the affected systems to regain their normal functionality. During this period, the Catecholamine and Glutamic Acid (NMDA Receptors) systems operate at a hyperactivity level whereas the GABA system experiences under activity. The combination of these processes results in the physical and mental manifestation of Alcohol Withdrawal symptoms.

Many patients experiencing Alcohol Withdrawal Syndrome complain of exaggerated levels of anxiety. This is because alcohol intake increases the creation of Brain-Derived Neurotrophic Factor (BDNF). During a withdrawal period, BDNF levels are significantly reduced and so anxiety symptoms are worsened.

 

Signs and Symptoms

 

Physical Symptoms

Clammy skin

Enlarged (dilated) pupils

Headache

Loss of appetite

Nausea and vomitin

Insomnia

Pallor

Sweating

Tremor

Rapid heart rate

Agitation

Confusion

Hallucinations

Seizures

Psychological Symptoms