Complications of alcohol withdrawal: Pathophysiological insights

Disease processes or events that accompany acute alcohol withdrawal (AW) can cause significant illness and death. Some patients experience seizures, which may increase in severity with subsequent AW episodes. Another potential AW complication is delirium tremens, characterized by hallucinations, mental confusion, and disorientation. Cognitive impairment and delirium may lead to a chronic memory disorder (i.e., Wernicke-Korsakoff syndrome). Psychiatric problems associated with withdrawal include anxiety, depression, and sleep disturbance. In addition, alterations in physiology, mood, and behavior may persist after acute withdrawal has subsided, motivating relapse to heavy drinking. Recent advances in neurobiology may support the development of improved medications to decrease the risk of AW complications and support long-term sobriety. KEY WORDS: AOD withdrawal syndrome; disease severity; disease complication; AODR (alcohol and other drug related) seizure; delirium tremens; Wernicke Korsakoff psychosis; anxiety state; emotional and psychiatric depression; sleep disorder; mood and affect disturbance; heart disorder; acute AODE (alcohol and other drug effects); AODD (alcohol and other drug dependence) relapse; GABA receptors; glutamate receptors; sex hormones; drug therapy