Addiction to alcohol can be a serious debilitating condition that leads to a slow deterioration in physical and mental health. Because of the damage that alcohol does to both the user and the people around them, individuals who abuse alcohol often realise that it is necessary to stop drinking. However, sudden cessation of alcohol abuse can be dangerous as it can create a number of symptoms termed alcohol withdrawal. These symptoms range from extreme to mild, but it is often not possible to determine how an individual is going to react. Acute symptoms include insomnia, autoimmune hyperactivity, hand tremors, hallucinations, seizures, psychomotor agitation, depression and anxiety. In addition, the withdrawal of alcohol often occurs with a more chronic memory impairment caused by nutritional deficiencies that lead to Wernicke-Korsakoff syndrome, which is characterised by severe cognitive impairment, delirium, abnormal gait and eye muscle paralysis.
Following the acute symptoms, more protracted symptoms may ensue and it is often this period that convinces an individual to begin drinking again. Protracted withdrawal syndrome is characterised by symptoms that can last up to 1 year and can include all of the symptoms seen in acute withdrawal. However, alcohol can also have a sedating effect by acting on the glutamate and GABAergic systems in the brain. Alcohol activates the GABA system by acting on GABAA receptors, and as levels of alcohol fall, the levels of GABA in the brain fall, and this reduces the sedation of the individual, something which can lead to the development of anxiety and insomnia. Alcohol also inhibits the N-methyl D-aspartate (NMDA) glutamate receptor that is involved in excitability in the brain. When alcohol is withdrawn, the system becomes overly active and this can be a cause of seizures. Overactive glutamate receptors are also thought to exert neurotoxic effects and so alcohol withdrawal can lead to neuronal damage and brain dysfunction. As NMDA receptors are also involved in memory, the activation of NMDA receptors can complicate the memory impairment seen from the Wernicke-Korsakoff syndrome.
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