Alcohol Withdrawal

With prolonged exposure to ethanol, the brain adapts by down-regulating (i.e., reducing) the inhibitory GABA A receptors—especially the alpha 1 subunit of GABA A. Ethanol also inhibits the excitatory NMDA glutamate receptors, and the brain adapts by increasing or up-regulating NMDA receptors. Therefore, when alcohol use is discontinued there is a relative decrease in inhibiting (GABA) mechanisms and a relative increase in excitatory (NMDA) mecha nisms. The symptoms of alcohol withdrawal then emerge and commonly include tremor, sweating, anxiety or agitation, elevated blood pressure, increased pulse, increased respiration, headaches, nausea, vomiting, and light and sound sensitivity. If the withdrawal is more severe, grand mal seizures (usually only one) may occur 24-48 hours after the last drink.

Alcohol withdrawal may be accompanied by perceptual disturbances and is coded accordingly if the perceptual disturbance occurs with intact reality testing (i.e., the person knows that the perceptions are caused by alcohol). The perceptual disturbances may be auditory, visual, or tactile hallucinations or illusions. They are transitory and usually develop within 48 hours of cessation of drinking. "Alcohol hallucinosis" is a clinical term commonly applied to these perceptual disturbances.

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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