Alcohol withdrawal syndrome
alcohol withdrawalwithdrawalalcoholethanol withdrawalClinical Institute Withdrawal Assessment for Alcoholthe shakeswithdrawal from alcoholwithdrawal of alcohol consumptionwithdrawal symptoms
Alcohol withdrawal syndrome is a set of symptoms that can occur following a reduction in alcohol use after a period of excessive use.wikipedia
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Epileptic seizure
seizureseizuresepileptic seizures
More severe symptoms may include seizures, seeing or hearing things that others do not, and delirium tremens (DTs).
Provoked seizures are due to a temporary event such as low blood sugar, alcohol withdrawal, low blood sodium, fever, brain infection, or concussion.



Delirium tremens
delerium tremensalcohol withdrawal deliriumDT
More severe symptoms may include seizures, seeing or hearing things that others do not, and delirium tremens (DTs).
Delirium tremens (DTs) is a rapid onset of confusion usually caused by withdrawal from alcohol.


Diazepam
ValiumDizacCANA
The typical treatment of alcohol withdrawal is with benzodiazepines such as chlordiazepoxide or diazepam.
It is commonly used to treat a range of conditions, including anxiety, alcohol withdrawal syndrome, benzodiazepine withdrawal syndrome, muscle spasms, seizures, trouble sleeping, and restless legs syndrome.


Benzodiazepine
benzodiazepinesbenzodiazapinesbenzo
The typical treatment of alcohol withdrawal is with benzodiazepines such as chlordiazepoxide or diazepam.
These properties make benzodiazepines useful in treating anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal and as a premedication for medical or dental procedures.








Physical dependence
dependencedrug dependencyphysical
Alcohol withdrawal may occur in those who are alcohol dependent.
A physical dependence on alcohol is often managed with a cross tolerant drug, such as long acting benzodiazepines to manage the alcohol withdrawal symptoms.
Chlordiazepoxide
LibriumLimbitrolA-Poxide
The typical treatment of alcohol withdrawal is with benzodiazepines such as chlordiazepoxide or diazepam.
It is also indicated as a treatment for the management of acute alcohol withdrawal syndrome.

Tremor
tremblingshakingmuscle tremor
Symptoms typically include anxiety, shakiness, sweating, vomiting, fast heart rate, and a mild fever.

Psychomotor agitation
agitationrestlessnessexcitement
To be classified as alcohol withdrawal syndrome, patients must exhibit at least two of the following symptoms: increased hand tremor, insomnia, nausea or vomiting, transient hallucinations (auditory, visual or tactile), psychomotor agitation, anxiety, tonic-clonic seizures, and autonomic instability.
Trazodone
DesyrelOleptroTrialodine
Studies have found that magnesium or trazodone can help treat the persisting withdrawal symptom of insomnia in recovering alcoholics.
Alcoholism
alcoholicalcoholicsalcohol
In the Western world about 15% of people have problems with alcoholism at some point in time.
In a medical context, alcoholism is said to exist when two or more of the following conditions are present: a person drinks large amounts of alcohol over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.







Excitotoxicity
excitotoxicexcitotoxinglutamate toxicity
Homocysteine levels, which are elevated during chronic drinking, increase even further during the withdrawal state, and may result in excitotoxicity.
Excitotoxicity may be involved in spinal cord injury, stroke, traumatic brain injury, hearing loss (through noise overexposure or ototoxicity), and in neurodegenerative diseases of the central nervous system (CNS) such as multiple sclerosis, Alzheimer's disease, amyotrophic lateral sclerosis (ALS), Parkinson's disease, alcoholism or alcohol withdrawal and especially over-rapid benzodiazepine withdrawal, and also Huntington's disease.

Lorazepam
Ativanbenzodiazepine lorazepamdrug of the same name
However, benzodiazepines with intermediate half-lives like lorazepam may be safer in people with liver problems.
It is used to treat anxiety disorders, trouble sleeping, active seizures including status epilepticus, alcohol withdrawal, and chemotherapy-induced nausea and vomiting.


Clinical Institute Withdrawal Assessment for Alcohol
CIWAClinical Institute Withdrawal Assessment of Alcohol Scale, revised
The withdrawal process is typically followed using the Clinical Institute Withdrawal Assessment of Alcohol Scale, revised (CIWA-Ar).
Clonidine
Catapresclonidine hydrochlorideDuraclon
Clonidine may be used in combination with benzodiazepines to help some of the symptoms.
Clonidine, sold as the brand name Catapres among others, is a medication used to treat high blood pressure, attention deficit hyperactivity disorder, drug withdrawal (alcohol, opioids, or smoking), menopausal flushing, diarrhea, and certain pain conditions.


Alcohol dependence
alcohol dependencyalcoholalcohol dependent
Furthermore, disrupted GABA benzodiazepine receptor function is part of alcohol dependence and chronic benzodiazepines may prevent full recovery from alcohol induced mental effects.
Alcohol dependence is differentiated from alcohol abuse by the presence of symptoms such as tolerance and withdrawal.

Pregabalin
Lyrica
Very limited evidence indicates that topiramate or pregabalin may be useful in the treatment of alcohol withdrawal syndrome.
Evidence of benefit in alcohol withdrawal is poor as of 2016.



Haloperidol
HaldolHaloparidolhaloperidol decanoate
Antipsychotics, such as haloperidol, are sometimes used in addition to benzodiazepines to control agitation or psychosis.
Haloperidol is used in the treatment of schizophrenia, tics in Tourette syndrome, mania in bipolar disorder, nausea and vomiting, delirium, agitation, acute psychosis, and hallucinations in alcohol withdrawal.


Post-acute-withdrawal syndrome
protracted withdrawal syndromepost acute withdrawal syndromepost-acute withdrawal syndrome
This syndrome is sometimes referred to as the post-acute-withdrawal syndrome. Anhedonia/dysphoria symptoms, which can persist as part of a protracted withdrawal may be due to dopamine underactivity.
Gabapentin
NeurontinFranklin v. Parke-DavisGabapentin ER
Limited evidence supports the use of gabapentin or carbamazepine for the treatment of mild or moderate alcohol withdrawal as the sole treatment or as combination therapy with other medications; however, gabapentin does not appear to be effective for treatment of severe alcohol withdrawal and is therefore not recommended for use in this setting.
Gabapentin may reduce symptoms of alcohol withdrawal (but it does not prevent the associated seizures), alcohol dependence and craving.


Baclofen
KemstroLioresaloral baclofen
There is insufficient evidence to support the use of baclofen for alcohol withdrawal syndrome.
Discontinuation of baclofen can be associated with a withdrawal syndrome which resembles benzodiazepine withdrawal and alcohol withdrawal.


Dopamine
dopaminergic systemDAdopaminergic
Anhedonia/dysphoria symptoms, which can persist as part of a protracted withdrawal may be due to dopamine underactivity.
When people addicted to stimulants go through withdrawal, they do not experience the physical suffering associated with alcohol withdrawal or withdrawal from opiates; instead they experience craving, an intense desire for the drug characterized by irritability, restlessness, and other arousal symptoms, brought about by psychological dependence.




Acamprosate
Aotal
There are three medications used to help prevent a return to drinking: naltrexone, acamprosate, and disulfiram.
The drug also protects cultured cells from excitotoxicity induced by ethanol withdrawal and from glutamate exposure combined with ethanol withdrawal.

Benzodiazepine withdrawal syndrome
benzodiazepine withdrawalwithdrawal syndromebenzodiazepine
Other conditions that may present similarly include benzodiazepine withdrawal syndrome (a condition also mainly caused by GABA A receptor adaptation).


Alcohol (drug)
alcoholdrinkingdrink
Alcohol withdrawal syndrome is a set of symptoms that can occur following a reduction in alcohol use after a period of excessive use.
Anxiety
anxiousnervousnessanxieties
Symptoms typically include anxiety, shakiness, sweating, vomiting, fast heart rate, and a mild fever.


