Alcoholic Withdrawal Syndrome is characterized by a set of symptoms observed in people who discontinue alcohol consumption after a history of addiction. Symptoms usually appear between 48 to 96 hours after stopping.
Causes
According to the literature, acute alcohol consumption has an inhibitory effect on N-methyl-D-aspartate (NMDA) receptors and has an agonistic effect on GABAA receptors, reducing excitatory neurotransmission, while chronic ingestion has different effects. in the same receivers. Thus, when alcohol intake is interrupted over a period of time, it leads to an increase in the regulation of N-methyl-D-aspartate receptors and a decrease in GABAA receptors as part of the human body’s homeostatic response (Sana et al. , 2003) and it is this adaptation that emphasizes hyperexcitability and many of the symptoms that come from withdrawal.
Symptoms
The clinical manifestations can vary taking into account the history of consumption, the quantities ingested over the years, age or genetic predisposition. However, among the main symptoms are:
- Tremors
- Increased sweating
- Accelerated pulse
- Insomnia
- Nausea and vomiting
- Anxiety
- Irritability
This syndrome becomes more dangerous with the onset of delirium tremens , a condition in which the patient presents:
- Mental confusion
- Hallucinations
- Convulsions
It is estimated that 5% of patients who progress to these symptoms die, due to cardiovascular collapse, dehydration or concomitant infections.
Diagnosis
In order to make the diagnosis of abstinence, it is necessary that the patient has at least reduced the volume of alcohol intake, that is, even if he does not stop completely, it is possible to appear abstinence.
Treatment
Treatment aims to decrease symptoms, prevent possible complications and deter alcohol consumption.
The treatment of alcohol withdrawal can be divided into non-pharmacological treatment and pharmacological treatment.
Hospital or home hospitalization, as well as outpatient follow-up are part of the non-pharmacological measures to treat this syndrome.
Pharmacological treatment includes vitamin and electrolyte replacement, with the aim of correcting metabolic and nutritional changes resulting from excessive alcohol consumption, and the use of psychotropic drugs in order to treat neuropsychophysiological changes. There are also medications that help to reduce the desire and compulsion to drink, preventing future relapses.
