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Is Alcohol Withdrawal Syndrome A Serious Condition? Causes, Symptoms, Risk Factors And Treatments

Alcohol withdrawal syndrome is a clinical syndrome experienced by heavy drinkers who suddenly reduce, discontinue or abstain from alcohol consumption after a long-term dependence.

People who stop drinking without any help from medical experts face alcohol withdrawal syndrome, often followed by hospitalisation due to certain medical consequences. The condition can range from mild to moderate to severe. For mild/moderate forms of alcohol withdrawal, the symptoms can be managed by patients while severe forms require medical treatment and can be life-threatening. [1]

In this article, we will discuss details on alcohol withdrawal syndrome. Take a look.

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Causes Of Alcohol Withdrawal Syndrome

GABA or Gamma-aminobutyric acid is the inhibitory neurotransmitter of the central nervous system (CNS) or say, it blocks or inhibits the brain signals. On the other hand, glutamate is an excitatory neurotransmitter that helps send brain signals and produces euphoria and behavioural excitement.

Chronic alcoholism causes depressant effect and adaptive changes in these neurotransmitters due to the development of tolerance. This results in down-regulation in the function, number and sensitivity of GABA and up-regulation in the function, number and sensitivity of glutamate.

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In short, the glutamate receptors get increased during prolonged alcoholism so as to compensate for the slow-growing depressant effect of alcohol. [2]

When the consumption of alcohol or depressant suddenly stops, the mind experiences an acute fall in GABA and an acute increase in glutamate, causing hyperexcitability, followed by the development of alcohol withdrawal syndrome within a few hours after the intake of the last alcohol.

Symptoms Of Alcohol Withdrawal Syndrome

The signs and symptoms of alcohol withdrawal syndrome are divided into different stages. They are as follows:

Within 6-12 hours after the last drink

  • Tremors [3]
  • Unusual sweating
  • Craving for alcohol
  • Nausea/vomiting
  • High blood pressure
  • Irregular heartbeats
  • Abnormally high body temperature
  • Rapid breathing
  • Anxiety
  • Vivid dreams
  • Agitation
  • Loss of appetite

Within 12-24 hours after the last drink

  • Alcoholic hallucinosis such as dysperceptions (visual, auditory and tactile). In short, seeing or hearing things that do not exists.

Within 24-48 hours after the last drink

  • Alcohol withdrawal seizures

Within 48-72 hours after the last drink

  • Delirium tremens such as psychosis, hallucinations, extreme confusion, malignant high blood pressure, extreme agitation, seizures and coma. [4]

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Risk Factors Of Alcohol Withdrawal Syndrome

  • Higher levels of alcohol intake
  • Abnormal liver functions
  • Longer duration of alcoholism
  • Past experience of seizures or delirium tremens
  • Acute illnesses
  • Older age
  • Use of other drugs along with alcohol
  • Past trauma

Diagnosis Of Alcohol Withdrawal Syndrome

The symptoms of alcohol withdrawal are noticed within 1-3 days after the cessation. The medical experts first take into consideration the medical and personal history of the patient.

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In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), the condition is diagnosed when these two conditions are met: the clear evidence of alcohol reduction after heavy drinking and the occurrence of symptoms without any medical, behavioural or mental disorder. [5]

For a physical test, the blood test is carried out to measure the amount of alcohol in the body of the patient.

Treatments Of Alcohol Withdrawal Syndrome

  • Detoxification: It includes weaning a person from the psychoactive substance by reducing the dependence or substituting it with cross-tolerant agents. [6]
  • Supportive care: Here, people with seizures are given intravenous fluids to lower their symptoms of dehydration and vomiting, followed by adequate nutrition, adequate sedative and intramuscular lorazepam (drugs that provide a calming effect).
  • Medications: It includes medications like benzodiazepines to treat severe forms of alcohol withdrawal. Other medications to treat mild symptoms such as excessive sweating, hypertension and many others.

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Common FAQs

1. How long does it take to feel better after you stop drinking?

Alcohol withdrawal syndrome is different for different people as not all experience the same symptoms. In some, mild symptoms appear after withdrawal and may go within days or a week, making them feel better. In others, the symptoms may get severe. Consult a medical expert if you notice severe symptoms within 1-3 days.

2. What happens when you give up alcohol?

For moderate drinker, giving up alcohol can cause certain psychological and physical symptoms such as nausea, headache and anxiety which may disappear after days or weeks. For heavy drinkers, sudden giving up on alcohol or without any expert help can cause complications like hallucinations and delirium tremens.

3. What is meant by withdrawal syndrome?

Withdrawal syndrome refers to a range of symptoms that occur when you give up on something addictive to your body such as alcohol, drug or tobacco.