Novel Targets Explored in Treatment of Alcohol Dependence induced Withdrawal Syndrome

Author(s):  
Antra Gupta ◽  
Heena Khan ◽  
Amarjot Kaur ◽  
Thakur Gurjeet Singh

: Alcohol withdrawal syndrome (AWS) is characterized as termination of chronic and sustained alcohol use that leads to severe symptoms of distress or loss of daily functions when alcohol consumption is diminished or stopped. It is a debilitating manifestation of alcohol dependence and responds poorly to the available clinical therapies. Globally alcohol drinking is continuously increasing all across the world. It causes 3.3 million deaths every year (5.9% of all deaths), and 5.1% of the global burden of disease. Alcohol Withdrawal syndrome led to various changes in brain neurotransmitters sys-tem such as GABA, glutamate, non-epinephrine, serotonin. These symptoms result from imbalance in brain receptor be-tween gamma aminobutyric acid (GABA) and N methyl aspartate (NMDA) that occurs when the consumption of alcohol stops after long use. Studies from various in vivo and in vitro animal models of alcohol withdrawal have been conducted to explore new targets for treatment of alcohol withdrawal syndrome. Advancements in the elucidation of AWS mechanism have revealed a number of key targets that have been hypothesized to modulate clinical status. The present review discusses the pathophysiology, neurobiology and treatment of alcohol withdrawal syndrome and its novel targets like corticotrophin releasing factor, sigma, melanocortin-4 receptors, opioid, potassium channels, ghrelin, and endocannabinoid receptors and gut microbiota. This review discusses about various clinical and pre- clinical aspects related with alcohol dependence. The exploration of novel pharmacological targets may provide effective therapeutic interventions for the management of alcohol withdrawal syndrome.

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Asish Subedi ◽  
Balkrishna Bhattarai

As the prevalence of alcohol dependence is approximately half in surgical patients with an alcohol use disorder, anesthetist often encounters such patients in the perioperative settings. Alcohol withdrawal syndrome (AWS) is one of the most feared complications of alcohol dependence and can be fatal if not managed actively. A 61-year-old man, alcoholic with 50 h of abstinence before surgery, received spinal anesthesia for surgery for femoral neck fracture. To facilitate positioning for spinal anesthesia, fascia iliaca compartmental block with 0.25% bupivacaine (30 mL) was administered 30 min prior to spinal block. Later, in the intraoperative period the patient developed AWS; however, the features were similar to that of local anesthetic toxicity. The case was successfully managed with intravenous midazolam, esmolol, and propofol infusion. Due to similarity of clinical features of AWS and mild local anesthetic toxicity, an anesthetist should be in a position to differentiate the condition promptly and manage it aggressively.


2015 ◽  
Vol 22 (1) ◽  
pp. 1-16 ◽  
Author(s):  
Roberta Agabio ◽  
Pier Paolo Pani ◽  
Antonio Preti ◽  
Gian Luigi Gessa ◽  
Flavia Franconi

The aim of this study was to evaluate whether the number of women recruited for studies to establish the efficacy of medications approved for treatment of alcohol dependence (AD) and of alcohol withdrawal syndrome (AWS) is sufficient to reveal possible gender differences in the response to these medications and in suggesting the use of different doses in female patients. Our results show that the rates of women recruited for studies evaluating the efficacy of disulfiram (1%), benzodiazepines (3%), and anticonvulsants (13%) were too low to establish possible gender differences. The rates of women recruited for studies evaluating the efficacy of acamprosate (22%), naltrexone (23%), and nalmefene (30%) were higher and allowed evaluation of data obtained for female patients. Women receive medications for treatment of AD and/or AWS for which efficacy has been demonstrated in studies in which men were more largely represented.


1980 ◽  
Vol 14 (3) ◽  
pp. 213-215 ◽  
Author(s):  
D. G. Lambie ◽  
R. H. Johnson ◽  
M. E. Vijayasenan ◽  
E. A. Whiteside

The value of sodium valproate in the management of patients during withdrawal from alcohol dependence has been assessed. Alcoholic inpatients were randomly allocated to two groups — one treated with sodium valproate and the other acting as a control. All patients received multivitamins and fluid and electrolyte replacement, and some received chlormethiazole or other tranquillisers. Treatment with sodium valproate (1200 mg daily) was continued for one week. The occurence of seizures and other withdrawal symptoms (tremulousness, nausea, sweating, disorientation) were noted daily. Forty-nine episodes of withdrawal have been included in the trial — 22 in the sodium valproate group and 27 in the control group. Five patients, all in the control group, had seizures. Other withdrawal symptoms disappeared more quickly in the sodium valproate group even though fewer patients were receiving chlormethiazole.


2013 ◽  
Vol 15 (2) ◽  
pp. 245-257 ◽  
Author(s):  
Katrin Skala ◽  
Fabio Caputo ◽  
Antonio Mirijello ◽  
Gabriele Vassallo ◽  
Mariangela Antonelli ◽  
...  

2018 ◽  
Vol 16 (4) ◽  
pp. 55-60
Author(s):  
Viktor V. Vostrikov ◽  
Petr D. Shabanov

40 patients with alcohol dependence in post-abstinent period was used to study the psychological peculiarities of emotional-motivational sphere during the course of placebo therapy. The placebo-reactor was 62.5%, placebo preaction – 15%, placebo-negative reactors of 22.5%. There are significant differences in the compared groups of patients. After a course of placebo-therapy all patients showed positive changes in emotional state, most pronounced in placebo-directoru. The least pronounced changes in the placebo group-negative patients (but to lessen the desire for alcohol most pronounced). The conclusion about the need for a differentiated approach to the treatment of alcohol withdrawal syndrome and postdetoxification state.


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