scholarly journals Single Cell Scale Neuronal and Glial Gene Expression and Putative Cell Phenotypes and Networks in the Nucleus Tractus Solitarius in an Alcohol Withdrawal Time Series

2021 ◽  
Vol 15 ◽  
Author(s):  
Sean J. O’Sullivan ◽  
Damani McIntosh-Clarke ◽  
James Park ◽  
Rajanikanth Vadigepalli ◽  
James S. Schwaber
Keyword(s):  
Gene Expression ◽  
Time Series ◽  
Alcohol Dependence ◽  
Alcohol Withdrawal ◽  
Negative Reinforcement ◽  
Nucleus Tractus Solitarius ◽  
Negative Emotion ◽  
Alcohol Withdrawal Syndrome ◽  
Withdrawal Time ◽  
Glucagon Like Peptide 1

Alcohol withdrawal syndrome (AWS) is characterized by neuronal hyperexcitability, autonomic dysregulation, and severe negative emotion. The nucleus tractus solitarius (NTS) likely plays a prominent role in the neurological processes underlying these symptoms as it is the main viscerosensory nucleus in the brain. The NTS receives visceral interoceptive inputs, influences autonomic outputs, and has strong connections to the limbic system and hypothalamic-pituitary-adrenal axis to maintain homeostasis. Our prior analysis of single neuronal gene expression data from the NTS shows that neurons exist in heterogeneous transcriptional states that form distinct functional subphenotypes. Our working model conjectures that the allostasis secondary to alcohol dependence causes peripheral and central biological network decompensation in acute abstinence resulting in neurovisceral feedback to the NTS that substantially contributes to the observed AWS. We collected single noradrenergic and glucagon-like peptide-1 (GLP-1) neurons and microglia from rat NTS and measured a subset of their transcriptome as pooled samples in an alcohol withdrawal time series. Inflammatory subphenotypes predominate at certain time points, and GLP-1 subphenotypes demonstrated hyperexcitability post-withdrawal. We hypothesize such inflammatory and anxiogenic signaling contributes to alcohol dependence via negative reinforcement. Targets to mitigate such dysregulation and treat dependence can be identified from this dataset.

scholarly journals Intraoperative Alcohol Withdrawal Syndrome: A Coincidence or Precipitation?

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Asish Subedi ◽  
Balkrishna Bhattarai
Keyword(s):  
Alcohol Dependence ◽  
Spinal Anesthesia ◽  
Local Anesthetic ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
Spinal Block ◽  
Local Anesthetic Toxicity ◽  
Neck Fracture ◽  
Intraoperative Period

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.

scholarly journals Efficacy of Medications Approved for the Treatment of Alcohol Dependence and Alcohol Withdrawal Syndrome in Female Patients: A Descriptive Review

2015 ◽  
Vol 22 (1) ◽  
pp. 1-16 ◽  
Author(s):  
Roberta Agabio ◽  
Pier Paolo Pani ◽  
Antonio Preti ◽  
Gian Luigi Gessa ◽  
Flavia Franconi
Keyword(s):  
Gender Differences ◽  
Alcohol Dependence ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
Female Patients ◽  
Evaluation Of Data ◽  
Different Doses

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.

scholarly journals Complicated Alcohol Withdrawal - an unintended consequence of COVID-19 lockdown.

2020 ◽  
Author(s):  
Lekhansh Shukla
Keyword(s):  
Time Series ◽  
Likelihood Ratio Test ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Time Series Data ◽  
Alcohol Withdrawal Syndrome ◽  
Unintended Consequence ◽  
Series Data ◽  
Ratio Test ◽  
Changepoint Analysis

We report the change in incidence of severe alcohol withdrawal syndrome following COVID-19 related lockdown in India. A changepoint analysis of the time series data (between 01.01.20 to 11.04.20) shows an increase in average number of cases from 4 to 8 per day (likelihood ratio test: χ2 = 72, df = 2, p < 0.001).

Sodium Valproate in the Treatment of the Alcohol Withdrawal Syndrome

1980 ◽  
Vol 14 (3) ◽  
pp. 213-215 ◽  
Author(s):  
D. G. Lambie ◽  
R. H. Johnson ◽  
M. E. Vijayasenan ◽  
E. A. Whiteside
Keyword(s):  
Alcohol Dependence ◽  
Sodium Valproate ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
The Other ◽  
Withdrawal Symptoms ◽  
Control Group ◽  
Electrolyte Replacement

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.

Novel Targets Explored in Treatment of Alcohol Dependence induced Withdrawal Syndrome

2020 ◽  
Vol 19 ◽  
Author(s):  
Antra Gupta ◽  
Heena Khan ◽  
Amarjot Kaur ◽  
Thakur Gurjeet Singh
Keyword(s):  
Alcohol Dependence ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Clinical Status ◽  
Alcohol Withdrawal Syndrome ◽  
Therapeutic Interventions ◽  
Clinical Aspects ◽  
Gamma Aminobutyric Acid ◽  
Novel Targets

: 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.

Sodium oxybate in the treatment of alcohol dependence: from the alcohol withdrawal syndrome to the alcohol relapse prevention

2013 ◽  
Vol 15 (2) ◽  
pp. 245-257 ◽  
Author(s):  
Katrin Skala ◽  
Fabio Caputo ◽  
Antonio Mirijello ◽  
Gabriele Vassallo ◽  
Mariangela Antonelli ◽  
...  
Keyword(s):  
Alcohol Dependence ◽  
Alcohol Withdrawal ◽  
Relapse Prevention ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
Sodium Oxybate ◽  
Alcohol Relapse

scholarly journals Sensitivity to placebo therapy in patients with alcohol dependence in postwithdrawal period

2018 ◽  
Vol 16 (4) ◽  
pp. 55-60
Author(s):  
Viktor V. Vostrikov ◽  
Petr D. Shabanov
Keyword(s):  
Placebo Group ◽  
Alcohol Dependence ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Emotional State ◽  
Alcohol Withdrawal Syndrome

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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