Drugs used to manage alcohol withdrawal tend to target which receptor?
Alcohol withdrawal
Clinical features
The signs and symptoms of alcohol withdrawal reflect over activity of the autonomic nervous system.
The initial signs and symptoms of withdrawal begin from 6 to 48 hrs after drinking stops. They usually peak between 10-30 hours (McIntosh 2004).
Initial symptoms include: - sweating, agitation, nausea, tremor, irritability, and in a small number of cases transient hallucinations. These initial symptoms usually diminish by 48hrs.
A small percentage of people (5%) undergoing withdrawal experience delirium tremens. This is a serious condition characterised by severe agitation, tremor and hallucinations. This usually occurs 2-4 days following alcohol cessation. The mortality rate for this condition is 1-5% (Kasser 2004). Risk factors include:- abnormal liver function, old age, severity of withdrawal symptoms, concurrent medical illness, and heavy alcohol use.
Treatment
Alcohol enhances the effect of GABA on GABA-A, resulting in decreased overall brain excitability. Chronic exposure to alcohol results in a compensatory decrease of GABA-A neuroreceptor response to GABA. As a result when people stop drinking their brains become very excitable. For this reason benzodiazepines are the main stay of treatment.
Kasser C, Geller A, Howell E, Wartenberg A. Detoxification: principles and protocols. American Society of Addiction Medicine. Accessed January 20, 2004
McIntosh (2004) Alcohol and the nervous system. J Neurol Neurosurg Psychiatry 75 16-21
