ADVANCEMENTS IN UNDERSTANDING AND MANAGING ALCOHOL WITHDRAWAL SYNDROME: A COMPREHENSIVE REVIEW
DOI:
https://doi.org/10.22159/ijcpr.2024v16i6.5024Keywords:
Alcohol withdrawal syndrome, Alcohol dependence, Neurobiological mechanisms, Management strategies and Pharmacological treatmentAbstract
Alcohol withdrawal syndrome (AWS) is a clinically significant condition that can arise upon abrupt cessation or reduction of alcohol consumption in individuals with alcohol dependence. This review article provides a comprehensive overview of AWS, encompassing its epidemiology, pathophysiology, clinical manifestations, assessment tools, and management strategies. We discuss the neurobiological mechanisms underlying AWS, including the role of neurotransmitter systems such as gamma-aminobutyric acid (GABA) and glutamate, as well as neuroadaptive changes that occur with chronic alcohol use. Furthermore, we explore the spectrum of clinical manifestations associated with AWS, ranging from mild withdrawal symptoms to severe complications such as delirium tremens and seizures. Diagnostic tools and scoring systems commonly used for assessing AWS severity are examined, along with evidence-based approaches for pharmacological and non-pharmacological management of AWS. Additionally, we highlight emerging research areas and future directions in the field of AWS, including novel treatment modalities and potential biomarkers for predicting withdrawal severity and treatment response. This comprehensive review aims to provide clinicians, researchers, and healthcare professionals with a thorough understanding of AWS to facilitate early recognition, appropriate management, and improved outcomes for individuals affected by this condition.
Downloads
References
Rehm J. The risks associated with alcohol use and alcoholism. Alcohol Res Health. 2011;34(2):135-43. PMID 22330211.
Park SH, Kim DJ. Global and regional impacts of alcohol use on public health: emphasis on alcohol policies. Clin Mol Hepatol. 2020;26(4):652-61. doi: 10.3350/cmh.2020.0160, PMID 33053937.
Ramos Vera C, Serpa Barrientos A, Calizaya Milla YE, Carvajal Guillen C, Saintila J. Consumption of alcoholic beverages associated with physical health status in adults: secondary analysis of the health information national trends survey data. J Prim Care Community Health. 2022;13:21501319211066205. doi: 10.1177/21501319211066205, PMID 34991399.
Sachdeva A. Alcohol withdrawal syndrome: benzodiazepines and beyond. J Clin Diagn Res. 2015 Sep 1;9(9):VE01–VE07. doi: 10.7860/JCDR/2015/13407.6538, PMID 26500991.
Becker HC. Alcohol dependence withdrawal and relapse. Alcohol Res Health. 2008;31(4):348-61. PMID 23584009.
McKeon A, Frye MA, Delanty N. The alcohol withdrawal syndrome. J Neurol Neurosurg Psychiatry. 2008;79(8):854-62. doi: 10.1136/jnnp.2007.128322, PMID 17986499.
DE Witte P, Pinto E, Ansseau M, Verbanck P. Alcohol and withdrawal: from animal research to clinical issues. Neurosci Biobehav Rev. 2003;27(3):189-97. doi: 10.1016/S0149-7634(03)00030-7, PMID 12788332.
Stern RS. Psoriasis. Lancet. 1997;350(9074):349-53. doi: 10.1016/S0140-6736(97)05257-4, PMID 9251649.
Sachdeva A, Choudhary M, Chandra M. Alcohol withdrawal syndrome: benzodiazepines and beyond. J Clin Diagn Res. 2015;9(9):VE01-7. doi: 10.7860/JCDR/2015/13407.6538, PMID 26500991.
O CP. Drug addiction and drug abuse. In: Goodman and Gilman’s the pharmacological basis of therapeutics. 9th ed. Vol. 1996, New York McGraw-Hill; 1996.
Hedaoo PA. Herbal remedies of alcohol addiction. World J Pharm Pharm Sci. 2019;8(6):491-510. doi: 10.20959/wjpps20196-13962.
Jesse S, Brathen G, Ferrara M, Keindl M, Ben Menachem E, Tanasescu R. Alcohol withdrawal syndrome: mechanisms manifestations and management. Acta Neurol Scand. 2017;135(1):4-16. doi: 10.1111/ane.12671, PMID 27586815.
Louis MD, Trevisan A, Nashaat Boutros MD, Petrakis IL, Krystal JH. Complications of alcohol withdrawal pathophysiological insights. Alcohol Heal Res World. 1998;22(1):61-6. PMCID PMC6761825.
Hall W, Zador D. The alcohol withdrawal syndrome. Lancet. 1997;349(9069):1897-900. doi: 10.1016/S0140-6736(97)04572-8, PMID 9217770.
Jesse S, Brathen G, Ferrara M, Keindl M, Ben Menachem E, Tanasescu R. Alcohol withdrawal syndrome: mechanisms manifestations and management. Acta Neurol Scand. 2017;135(1):4-16. doi: 10.1111/ane.12671, PMID 27586815.
Canver GA, BR, Newman RK. Alcohol withdrawal syndrome Treasure Isl. StatPearls Publ. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441882. [Last accessed on 24 Oct 2024].
Suzdak PD, Schwartz RD, Skolnick P, Paul SM. Ethanol stimulates gamma-aminobutyric acid receptor-mediated chloride transport in rat brain synaptoneurosomes. Proc Natl Acad Sci USA. 1986;83(11):4071-5. doi: 10.1073/pnas.83.11.4071, PMID 2424017.
Schuckit MA. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J, editors. Harrison’s principles of internal medicine. 19th ed. New York: McGraw-Hill. Alcohol and alcoholism; 2015.
Kattimani S, Bharadwaj B. Clinical management of alcohol withdrawal: a systematic review. Ind Psychiatry J. 2013;22(2):100-8. doi: 10.4103/0972-6748.132914, PMID 25013309.
Kosten TR, O Connor PG. Management of drug and alcohol withdrawal. N Engl J Med. 2003;348(18):1786-95. doi: 10.1056/NEJMra020617, PMID 12724485.
Madhavan J. Ayurvedic management of alcohol withdrawal syndrome a case report. MJCCS. 2018;2(6):000184. doi: 10.23880/MJCCS-16000184.
Howard C Becker. Alcohol dependence withdrawal and relapse. Alcohol Res Health. 2008;31(4):348-61. PMID 23584009.
Published
How to Cite
Issue
Section
Copyright (c) 2024 AJEET PAL SINGH, ASHISH KUMAR SHARMA, THAKUR GURJEET SINGH
This work is licensed under a Creative Commons Attribution 4.0 International License.
