Alcohol withdrawal syndrome

Alcohol withdrawal syndrome is a range of symptoms that can develop when prolonged heavy alcohol use is abruptly reduced or stopped. It ranges from tremor and anxiety to seizures and delirium tremens.

GABA: Gamma-aminobutyric acid is the principal inhibitory neurotransmitter in the mammalian central nervous system. Alcohol enhances GABA-mediated inhibition; chronic exposure leads the brain to compensate.
Clinical Institute Withdrawal Assessment for Alcohol, revised: CIWA-Ar is a clinician-administered scale for rating the severity of alcohol withdrawal symptoms. It helps guide symptom-triggered treatment in patients able to communicate reliably.
Alcoholic hallucinosis: Alcoholic hallucinosis is a withdrawal-associated condition marked by hallucinations, often with relatively preserved orientation and attention. It illustrates that hallucinations can occur without the delirium characteristic of delirium tremens.
Alcohol intoxication: Alcohol intoxication is a reversible disturbance in behavior or function caused by recent alcohol consumption. Intoxication follows alcohol exposure, whereas withdrawal follows its reduction or cessation.
Glutamate: Glutamate is the main excitatory neurotransmitter in the mammalian central nervous system. Chronic alcohol use alters glutamate signaling, which can become excessive after alcohol is stopped.
Benzodiazepine: Benzodiazepines are drugs that enhance signaling at GABA-A receptors and produce sedative, anxiolytic, and anticonvulsant effects. They are first-line medicines for reducing withdrawal symptoms and seizure risk.
Alcohol withdrawal tremor: Alcohol withdrawal tremor is involuntary shaking that commonly follows a substantial reduction or cessation of heavy drinking. It is a common early sign in the withdrawal spectrum.
Alcohol hangover: An alcohol hangover is a short-lived collection of unpleasant symptoms after drinking, typically as blood alcohol concentration falls toward zero. A hangover is generally distinct from the potentially dangerous syndrome associated with prolonged heavy use.
Neuroadaptation: Neuroadaptation is the nervous system’s adjustment to repeated changes in its chemical or electrical activity. Compensatory adaptations explain why removing alcohol can leave the nervous system overactive.
Thiamine deficiency: Thiamine deficiency is an inadequate supply of vitamin B1, which can impair brain and nerve function. Heavy alcohol use commonly coexists with deficiency, so thiamine is addressed during withdrawal care.

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