Neurobiology of alcohol withdrawal: Changes inreward and stress response systems

Alcohol withdrawal is a syndrome which resulted from adaptive changes in the brain secondary to chronic alcohol use and is associated with changes in many neurotransmitter, neuropeptide, and hormonal systems. Most, if not all, of the systems that involved in the alcohol withdrawal are in some way related to the reward and/or stress system of the brain. Stressful events may increase the rewarding effects of the alcohol, and in turn, play an important role in the development of the alcohol dependence and craving, and relapses. Conversely, chronic alcohol use leads to some impairments in the stress response system of the brain. CRH plays a role in the rewarding/ enforcing effect, and at the same time, in the impacts on the stress system of the alcohol. In this paper, changes in the reward and stress response systems which are thought to be involved interrelatedly in the development of the alcohol withdrawal will be reviewed